11522 SW LAKEVIEW TERRACE f
11522 SW LAI EVIEW T'ERR
CITY OF TI CARD 711JILDING INSPECTION DIVISION
24-1-lour Ins ction Line: 6394175 Business Phone: 6394171
Date Requested: --/,, A.M. _ P.M. MST: _
Location:ion: I`� k17/f �XJI,1 (� (-JC-- – BUR— ._
Tenant: C/ �� _ Suite: Bldg- MEC:
Contractor:r tr _ —�Phone_(D ( 6 Cl PLM: O_ ?�
Owier•_ f" 4 0`1, _Phone: -- ELC:�
ELR:
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SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL — ELECTRICAL SITE
Site Post/Beam Post/13wm Cover/Service Sewer/Storm
Footing Roof 1JndFYS1al; Rojo.In Ceiling Water Line
Slab Framing Trip Out Gas Line Rough-In UG Sprinkler
I-oundation Insulation Sewer Fioxd/Duct f --connect Vault
Bsm(I)amp Drywall Storm Fur.lace Temp ServiceMISC.
Masonry Ceiliag Rain Drain A/C IXT SlabC�10- )
Shear/Sheath Fire Spklr/Aln Crawl/Found Ir- Ilea' Pump Low Volt
Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Noir Approved Not Approved �– of Approved
FINAL FINAL _ FINAL FINAL FINAL
O Call fnr y�tD�ti � O Rei7,zjl
on t-of S` tequir"ed fore next inspection 0 Unable to in9pect
Inspector _ Z�f��,/ 1)at —moi' Page— of
F TIGARD
CiTY O r,LUMBING PERMIT
DEVELOPMENT SERVICES r,ERMIT #. . . . . . . : PLM97--O355
13125 SW Hell Blvd.,Tigard,OR 97:.23 (503)09.4171 DATE ISSUED-
08/217/97
PARCEL-: 1 S 133DD-.05200
SITE ADDRESa. . . 152'.2 SW LAKEYIEW TEF;?
: 1 ,. r� LAKE WARN. 3 ZONING: R-4. 5
iL113IiIVISIC1hJ. . . . VILLAGE AT SOMME JURI''SDICTION; TIG
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LOT. . . . . . :91
BI_OC1%. . . . . . . . . . --------------------._____________------
-- -------------_`-- --GARBAGE-DISP'OSAI S. : 0 MOBILE HOME SPACES. : 0
CLASS OF WORK. . :ALT BACKFLOW !`'REYNTRS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 TRAP^5. . . . . . . . . . . . . . 0
FLOOR DRAINS. . . . . . : 0 '
OCCUPANCY GRP'. „ :R3 0 CATCH BASINS. . . . . . . : 0
STORIES. . . . . . . . : 0 L,AUNDWATER HEATERS. . . . ,
FIXTLJRES---• _.._.._._..--- --.
LAUNDRY T 2A'!S. . . . . : vi ��F RRIN DRAIN`. • • • • 0
SINKS. . . . . . . . . : 0
URINALS. . . . . . . . . . �' UREASE TRAF'5. . . . . . . :
I__AVi�TOR�.E�;. . . . : +r OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 4� SEWER LINE (ft ) . . . : 0
WATER CLOSETS. - 0 WATER LINE (f t ) . . . :
RAIN DRAIN (ft ) . . . :
DISHWA9HERS. . . . : 0
Remarks : Install residential backflow prevention device
FEES -__---- -----
__ ....------ -
Otype wner: --
...-__._ -'---�- amo+_mt by date rec:
ELIZABETH JACKSON PRMT f 15. 00 JSD 06/27/97 97-298721
1152:2 SW LAKEYIEW TERR 5PCT f 0. 75 JSD O8/27/97 97-298721
T I CARD OR 97223
IPht)ne #:
Contractor .-------
NATURAL TOUCH LANDSCAPING INC
,_25O5 BENTS RD NE.
c)I_IRORA OR 07OO2 _ `$ 15. 75 TOTAL
t'hone #: 03-678-138
Rey #. . : 6811 _--_-__.- REQUIRED I NSPECT 17N: - -- - -
RP/Backflow Prev
This permit is issued subje _—_----
ct to the regulations contained in the +— -
liyard Municipal Code, State of tMv. Specialty Codes and all other Final Inspect ion
applicable 1W. All Mork Mid bo done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of iso++.ncc, or if work is suspended for morethan 180 days. ATTENTIfIN: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are -
set forth it OAR 952-eeel-001Q+ through OAR 952-0081-0080. You may r
obtain fQpl95 of these rules nr direct questions to OX by call'.';”
(503)246-1967. --- --•
Permr
Permittee SiVat"' e:
issued
++++++ ++++f++�4+++++++•.+++++++++++++ins*act*on+neederi+t;he+next+b iciness+iay+++
Call 639-4175 by 6:00 p. nr. for .an P
,ITY OF 'TIGARD Plumbing Application Date F:ee
r d
3125 SW HALL BLVD. Commercial and Residential Date / T
iGARO, OR 97223 Dam to P E.Oslo to osr
iO3j 639-4171 Permit r
Print or Type Related SWR r
Incomplete or illegible applications will not be accepted caftd -
-- --Tema•if DevebpmentlProtect .FUCTUREB,L±rldual) ►�i�{bx'� GT,�fj �P)%CE.it,
Sink
Job �- I �' /.3 f i Y IJ/�-c k r •, _ 9.c�
Address Street Address Suate Lavatory 9.00
L41(r Uit w c Tub or Tub/Shav-wComb. 9.00 --
Bldg r 1 Ci !slate ZIP Shower Only - 9.0G
Web/f Closet 9.00
Name Oli'nwaeher -
C- i� 9.00
Owner WaWV Address slate Or�a9*f"1+voe+t 9.00
"L uti' e-.^i k ✓I• k r.t. Hhrhhty Aitadhne 9.00
City/State ZIP Phone F bor Drain, 2' 0.00
- 2i� 0a `I-)zs )-1-''17� 4
- 3' 9.00
Name
4- 9.00
Oct.upant Madng Address Suits Water Neater _ 9.00
Uw ry Room Tray 9.00
CINIState - ZIP -- Phone Urinal --- �- ---- 0.00
-- - Other Fix i es(Specify) 9.90
Name
I.WA I i ilei r_rr O's 14 J N 9.00
ontractor madft Address Suite 9.00
L 3 !.175 �'•1k'C'-� - 9.10
for to sauanCe Clty/Stste ZIP Phone -
aoplicant must 41.4F, z OR i)U/ ._ 3-c"'s C re I ?2 i 9.OG
Provide ad Oregon Corset.Cont Board L,c.r Exp.Date 9.00
contractors •3y Jr 9.00
se
IncenPtumtwtg Lic,r Exp.Date y- Sewer-1st 10(r --- 30.00
information , ) ) __ J I�/ /,-rSmrer-each additional 100' 25.10
(Of COT COT Business Tax w Metro r Exp.DateT Water Service-to 100' - 3G,OO -
ialabas,91- _ _
Nafne �- Water Service-each additional 200' 25.00
\rchitect Storm d Rain Clean-1st 100'
or Mailin9 Address Suite - Slorm d Ran Fran-each additional 100' - -25.00
Mobd*Flame Spam 25.00
=ngineer Gty/State - Zip Phone Commercial Sacli Flow Preventm Device or Ain►-
F2500
- PoriAdon Devk:e _
smbe worlt New O Addition O Alteration O Repair O Residential a"ficiw Prevention Dersce' 15.09
A dome- Residential O Nun-iesdenhal O My Trap or Waste Not Conneued to a Fixture 9 00
drtional desmpbon of work -- -- - -
Catch Basin 00
Irtsfr.cf t awtlnq Plumb" 40-)0
_ per/hr
ting use of Specially Requested Inspecoons ------ -- 4000
_ txr/N
ding or property -- Rain Drawn.strtgb famtfy dwelling --- -10.00
dosed use of Grease Traps -_W 9.00
ding or property--_
_ QUANTITY TOTAL
e you capping, moving or replaong any fixtures? Yes❑ Nc,O lacer we or nw diagram is rt*mm if Ouarwy Tutsi w >9 •.tv %..ir r
"yes see beck of tomi) _ - 'SUBTOTAL
,!reoy ackna~ge that I have-read this aaplicahon,that the information
,n is correct.that I am the owner or authrrizel agent of the owner.and 5`1. SURCHARGE
plans subirtrtted are in compliance wttlh O ori Stats Laws
iature of OwmerfAgrint i Dat* PLAN REVIE.N 25% OF SUBTOTAL ,
r4"Ur"OnN 1 tr"jmyy tali is t 9 - -
TOTAL
LAct Person Nam* -------- Phone iv -
Minimum permit fee is S25-5%aurcha ,e.except Residennal Backflow
-- -- Prevention Device.which is S15•5%surcharge
Lpltnapp.doc 12,96 Wst)
LLEASE CQMPLETE AS APPROPRIAIE APPROPRIATE1O PROJECT:
Fixtures to be capped, moved or replaced —Qty
Sink
Lavatory —
Tub or T'ub/Shower Combination
Shower Only
Water Closet
Dishwasher _
Garbage Disposal _
Washing Machine
Floor Drain 2"
_ 4"
Water Heater w�
Laundry Room Tray _
Urinal
Other Fixtures (Specify)
;OMMENTS REGARDING AEG'. E:
I:,plmapp doc 12.'96 (dst)