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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 639-4171
Date Requcsted: �' _-- A M. _ p M MST:
location:_ 9 90 5 _--- �" BUP:
Q_ @y.
Tenant �_ Suite: Bldg: MEC- d
Contractor. ,Phone: —_
Owner: / Phone. _{!� — '3�J,:x� _._ EI,C:
ELR:
SIT: _
BUILDING BLDG(con't) `UMB - MECHANICAL ELECTRICAL SITE
>Beam
Sit( Post/Beam PMtPosbBcam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-Ip Ceiling Water Line
Slab Framing Top Out (� Cyas Line Rough-In UG Sprinkler
Founeation Insulation Sewer Hood/Ihict Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain DraA/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt
Approved p ov Approved Approved Approved
N'
Ajyndwlk Not Approved pproved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
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Cl Call torr reins O Reinspection fee of Srequired before next inspection O Unable to insVect
Inspector: �-=� Date —7��_— Page—/_of J
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc. 639A 175 Business Phone: 6394171
Date Requested: I A.M. P.M.�—� MST:
Location: BUR
Tenant:, Suite: Bldg: MBC:
Contractor: Phone: — PLM:� �J
Owner: �p
wner: Phone.. _ �7 �. �_ ELC:
_ ELR: o
STI':
BUILDING BLDG(can't) PLUMBING..' MECHANICAL ELECTRICAL SITE
Site Post/Beam �J PosUBeam Cover/Service Sewer/Storm
Footing Roof Undl'I/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer (�� Hood/Duct Reconnect Vault
Hsmt Darnp Drywall Storm t Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm CrawUFound Dr Heat Pump t.ow Volt _
Approved A Approved Approved Approved
LAppr1Sdwlk Not Approved Not proved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL
OC
.S A.
,LfF 1
tint ,
l for rci ti D Rcinsl on fee o S _required before next inspection O Unable to inspect
' : Date: '' Page--of
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CITY OF TIGARD PERMIT
DEVELOPMENT SERVICES PLUMBING IE
PERMIT #. . . . F. . . . : Pl_.M9 7-0266
13125SWHOYBlvd., Tlg8rd,aR97223 (503)639.4171 DATE ISSUED: 07/09/97
I,
PARCEL: 2511/eHA-00600
SITE ADDRESS. . . : 09905 5W SERENA WAY ,
SUBDIVISION. . . . : PICKS LANDING NO. 2 ZONING: R-4. 5 �
BLOCK. . . . . . . . . . . LLAT. . . . . . . . . . . . . : 133 JURISDICTION: TIG
------------------------------- �,
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . ..SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 1 CATCH BASINS. . . . . . . : 0
FIXTURES--------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 >
TUB/SHOWERS. . . : 0 SEWER LINE (ft) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Replace elec water heater
Owner. -- ---------------------------------------------------- FEES --------------
HETHANE KRONICK type amount by date recpt
9905 SW SERENA WAY PRMT $ 25. 00 JSD 07/09/97 97-296924 `
TIGARD OR 972 :4 5PCT $ 1. 25 JSD 07/09/97 97-•2:9692,4
Phone #: 639-1353
Cont Tact or-------- -----------------------..__....._ ._.__. 1
GEORGE MORLAN PLUMBING & APLIANCES
125615 SW PACIFIC HWY
CCH (EXP 6/2002)
TIGARD OR 9722223 ---------------------------------------
Phone
--------------------------------------
Fhone #: 624-6695 $ 26. 25 TOTAL_
Reg #, . : 000027
------- REQUIRED INSPECTIONS -------
This permit is Issued subject to th. regulations contained in the Misc. Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All Mork will be done in accordance 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 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are ! _
set forth in OAR I52J1 0010 through DAR 952-0001-0080. You may
obtain copies of these rules or direct questions to OLINC by calling
1503)246-1987.
l s s i-red H -� P e r m i t t e e S i gnat
4++++++.........4....+++++t+f+fff............... 1..... t+f..t....}i...4. ..........
Call 639-4175 by 6:00 p. m. for an inspection needed the next business day
.....++++++++++++++++++......++++++f.++++++++++++++++++++++++++++++++++++++++++
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;ITY OF -rIGARD Plumbing Application RBCO8y_
' 3125 SW HALL BLVD. Commercial and Residential Dale Recd o �`
TIGARD, OR 97223 Date to P E
503) 639-4171 Cate to DST
P,.rmlt a L-M '� 60 41
Print or Type Related SWR s _
Incomplete or illegible applications will not be accepted called
10 65—
Name a!CevetoomenuProlect FIXTURES (Individual) QTY PRICE_ AMT i
' Job r Sink
Addiess $,reel Address Lavatory
9.00
.
�•�q�5^�J
rut?or Tub/shower
Camp 9 00 i
Ttyrstile Lip 37ho.e,Unry
TIC.—gr9 00 _
N e water t:losel 9.00
l7G�rl•ifr►y ?�ylivl� Dishwasher 900
Owner titadinogres Suite Garbage Disposal
°I9ot, x`Zdgt-'lA` 900
1 Washing Machine —
i
`-,N,5ple L,p Phone Floor Dram 2-
900
-- —-- T(G-T-V_p e) (_--2, . ( 900
Nary» 3 9.00 `
:•�►N,G a 8.00 f
Occupant Mailing Address Suite Water Heater I 900
Laundry Room Tray--�
C ty,State Zip Phone 9.00
Unnal 9.00
N me other fixtures ISpeciyl 9.36
o r,a24.4�J p�aV
Contractor Mailing Address — 9.00
Suite
11JG9.00
>P,�. I�tav —
:Pnor to Issuance 71tylStale Zi 9.00
loolicanl must ti&A42 -> P Phone
arowde all Oregon Const.Cont.Board Lic s Exp Date 9 00
:ontrac:ors 'c
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license Plumbing Llc.s 8,00
nfonnaaon ZV teop f3 P Date Sewer- tst t00' 30.00
`rr COT COT 0uslness Tax or Metros Sewer-each additional 100' 25 00
F�rp Date
-mtaDaseL I GICp _ Water Service-131 100, 30.00
Name :later Service•each adtLtionai 200• 25 00
Hrchitt!ct Storrn d Rain Drain- tsl 100 30 00
or Mailing Address I Suite Storm d Rain Drain-each addltional 100' 25.00 _
Mobile Home Space
Engineer CltyrSlate Zip Phone 25 00 1
Commercial Banc Pow Prevention Device or Ant.- 2500
Pollubon Device I
•asc❑De.rant N w
e >adCyen Alteration O Recau C aesidenhal 9acxlow-2vention Cevite'
a oe clone Res,dentrat S' Non-residential 0 15 00
�aai^onal aescnonon of wont
Ary Trap or-Nasi NV Conneced;o a Fixture I I 9 00
"1Z✓<Pi-A4-a2. CZIH'G I.�F-F Catch 3a�,n � I 900
nsp of Existing:umo,ng I +0.00
per/hr
hating use of Specialty Requested InspectionsI 40.00
JIkl:n
g or prose rrY I, 30
Rain RaCrain single'amity dwetling 30 l — 30
''noosed use of Grease Traps
:uilo,rg or arooeny I 9 Co
ire ,ou capping moving or replacing any fixrures7 ves 70� QUANTITY TOTAL I
Ixprrey c lr nfK iN>raT f !^_UKId 1 Quanrty-Cral f >j
Ili yes see back of forint -
nereny acknow edgehat;have read;h s application.that the nformaCon 'SUBTOTAL
liven!s correct that I am:he owner or authonzed agent of:he owner and
:hat Plans suDmitted are - :ompliance with Cre on State Laws. 5". SURCHARGE
Signature owner/Ager• Date PLAN—REVIEW 25:'.OF SUBTOTAL
Rer.vrn ann t'E,: v orar.t>g
Contact Person Name PTOTAL ,
hone _ � �,�•'
(� Y11.OrL� �NA'�t� � , 11 i�imum permit fee 1s 525-3',G surcharge.except Residential 9acktlow
3 I Prevention Device.rm,ch is Sts•5'4 surcha e
i,'41113 olmapp doc sig
F
at EASE�C,��VLPLETE AS APP��RIAT� TO PRO.1�C�•
Fixtures to be capped, moved or replaced Qty
L§.�k
(-Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet _
Dishwasher
Garbage Disposal
Washing Machine — !_
Floor Drain 2"
Water Heater
Laundry Room Tray
Urinai _�_�
Other Fixtures (Specify)
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OOMMENTS REGARDING ABOVE:
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