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Permit
r 71 ti JV CITY OF TIGARD PLUMBING PERMIT , ° r' COMMUNITY DEVELOPMENT PERMIT #: PLM2008 -00351 • i 1 : 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/26/2008 PARCEL: 2S 11380 - 00600 SITE ADDRESS: 16580 - 85TH AVE ZONING: I - SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG PROJECT: CLEAN WATER SERVICES Project Description: Installing 500 ft. of water service and (2) backflow preventers. CLASS,OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2 OCCUPANCY GRP: UNK FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 500 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES CLEAN WATER SERVICES • 2550 SW HILLSBORO HWY Description Date Amount HILLSBORO, OR 97123 -9379 [PLUMB] Permit Fee 8/26/2008 $333.40 [TAX] 12% State Surch 8/26/2008 $40.01 Phone : 503- 681 -3600 Total $373.41 Contractor: NORTHWEST EARTHMOVERS INC PO BOX 1609 SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS 03 i Contact # : PRJ 503 -625 -3100 O FAX 503- 625 -3108 O Reg #: LJC 62761 W • This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work 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 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by c -llin• 503.246.6699 or 1.800.332.2344. r Issued B - � e 1 1 - • �� `-- Perms ee Signature: �,-- - - - g �_rc �� Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • V CITY OF TIGARD PLUMBING PERMIT COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00351 » '\ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/26/2008 PARCEL: 2S113130-00600 SITE ADDRESS: 16580 SW 85TH AVE ZONING: I -P SUBDIVISION: SEWER TREATMENT PLANT LOT: JURISDICTION: TIG PROJECT: CLEAN WATER SERVICES Project Description: Installing 500 ft. of water service and (2) backflow preventers. CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 2 OCCUPANCY GRP: UNK FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 500 ft DISHWASHERS: RAIN DRAIN: ft Owner: FEES CLEAN WATER SERVICES 2550 SW HILLSBORO HWY Description Date Amount HILLSBORO, OR 97123 -9379 [PLUMB] Permit Fee 8/26/2008 $333.40 [TAX] 12% State Surch 8/26/2008 $40.01 Phone : 503- 681 -3600 Total $373.41 Contractor: NORTHWEST EARTHMOVERS INC PO BOX 1609 SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS Contact # : PRI 503 -625 -3100 FAX 503 -625 -3108 Reg #: LIC 62761 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work 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 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued B, . " / � Permiffee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Plumbing Permit Application t - -, ? t-.- a`v'"7e„ �' s«,x.0,,, •v441p 4.. 9 * Bwldin Fixtures `„ -�~ � -. k '--, � 41 FOR r OFFICE USE ; l a t } Ci ty o Tigard `4- Date /B d V p Permit No.: R �) • N. il r, t. a 13125 SW Hall Blvd., Tigard, OR 0014'4,i,.....- Plan Review V, . C '_ Phone: 503.639.4171 Fax: 503. �• y.; :.,.. 4 _J DateB Other Permit No.: "' 0 l I ', A -. D Inspection Line: 503.639.4175 (.� A Z Date Ready /By: Juris: ® See Page 2 for _s.-,�r. Internet: www.tigard - or.gov A ll y ® Notified/Method: 776' Supplemental Information I t �� - ' TYPE. OF. WORK FEE* SCHEDULE [! New construction ❑ - r . ' � 4` For special information use checklist k•. D escription Qty. Ea. I Total ['Addition/alteration/replacement ■ru New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 01 j Each additional bath/kitchen 45.00 ❑ Master builder Lf Other: 0411, i , 1 Fire sprinkler ( sq. ft.) Page 2 - . . -JOB" SITE. INFORMATION. - 1 L 1 CATION Site utilities Job site address: S J TN A t/e _`1otafi 541 � s ,4j/-E Catch basin or area drain 16.60 l /r /State /ZIP: A Cr2 1 Cit y C 722 -4/ Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: f Project name5/9STZ ,4 :A 7 .6 ,J Footing dram (no. linear ft.: _) Page 2 !a Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 {� h as c !i v AE $"oCiT- GF 4.../12#14r1-4 as Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: Water service (no. linear ft.: )j 5 Page 2 pmt 6 t Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Backflow preventer 2i Page 2 Ws. • /l/ !/4L.(_ S317' - /' 4 C / - ..�.f26,t) T/ ' Backwater valve 16.60 /W , . (- q "/ RP ) ei vJc , Clothes washer 16.60 J RP !J Dishwasher 16.60 (PROPERTY OWNER I . • ❑ TENANT.. Drinking fountain 16.60 CL EA Ejectors /sump 16.60 Name: C..jE' WA?F� /a-.S Expansion tank 16.60 Address: d pg,U s ' ( , ) e S Fixture /sewer cap 16.60 City /State /ZIP: 7 79/f• 972 Floor drain/floor sink/hub 16.60 / Garbage disposal 16.60 Phone: ( 4 5 6 / g3 Fax: ( ) APPLICANT Hose bib 16.60 ❑.CONTACT PERSON ,/ Ice maker 16.60 Business name: N lnIFSTt�T1� /ll/jUl//� �nl C, Interceptor /grease trap 16.60 Contact name: (/ f'/./ Z.60"F Medical gas (value: $ ) Page 2 Address: ,o0 ,e, /b 9 Primer 16.60 City /State /ZIP: ��5,2,,,,,,,,,,,L V/ 9 7, 2-‘7i Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( 50 3 ) G i 33 = 340-0 Fax: : (5 635 - 3,,e r Tub /shower /shower pan 16.60 E -mail: TLae&Eci Ahig /9ATf�/yleuF2S. Gam. . Urinal 16.60 / . .CONTRACTOR : _ Water closet 16.60 Business name: g 45 /4Baj( Water heater 16.60 Address: Other: City /State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 333 r , CCB Lic.: z76/ Plumbing Lic. no.:34l- TAT .� Plan review (25% of permit fee) Authorized signature: �- State surcharge (12% of permit fee) . 0 2.,2;...-_,,,, -, PERMIT FEE 2 7 ?. Print name: Amt,/ Date: f' 2i4 ea This permit application expires if a permit is not obtained within / 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. 1:\ Building \Permits\PLMF- PermitApp.doc 12/27/06 440- 4616T(10/02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential.Fire Suppression Systems: Site Utilities Qty;.: Fee (ea) 'Total • Square Footage. Permit Fee Footing drain - 1" 100' 55.00 0 to 2.000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 -7,201'andgreater. $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 0/ 55.00 u Medical Gas Systems: Water Service - each additional 100' G 46.40 i Q Valuation: •Permit Fee:. . . Storm &Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Fl%ture or Item Qty. Fee (ea) • • ':;Total additional $100.00 or fraction thereof, to and e \ _ including $10,000.00. Commercial Back Flow Prevention Device Z 46.40 y2, O P (J $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and.including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for 53 �, L) each additional $100.00 or fraction thereof. Commercial Fixture Work: Pla Plumbing:Installations Are you capping, adding or replacing fixtures? If "yes ", Plan review is required for any of the following. please indicate work performed by fixture. Failure to Please check all that apply. accurately report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water service 2" and - - Quantity_ by (Fixture) Work Performed greater, except systems designed and stamped by licensed Fixture Type <; Replace engineer. Previous . Capped Added . . Existing , ❑ New exterior plumbing site utilities for any complex structure Baptistry/Font as defined in OAR918- 780 -0040. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities. - Jacuzzi /Whirlpool ❑ Any multipurpose fire sprinkler system. Car Wash -Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040. -Drive Thru Cuspidor /Water Aspirator Submit 2 sets of plans with any of the above. Dishwasher - Commercial - Domestic . • Drinking Fountain 'Isometric or Riser Diagram Eye Wash ❑ Isometric or riser diagram is required for new buildings Floor Drain /sink - 2" that meet the qualifications above. 3" 4 ,. Car Wash Drain Garbage -Domestic Comments regarding fixture work: Disposal - Commercial - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley *Note: If the fixture work under this permit results in an - Commercial increase of sewer EDUs, a sewer permit will be issued and - Service fees assessed for the sewer increase must be paid before the Swimming Pool Filter plumbing permit can be issued. Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: i:\Building'Permits\PLM- PermitApp.doc 12/27/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: PR..M2008.00351 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 812.62008 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 r� INSPECTION WORKSHEET FOR DATE: 8/29/2008 TIME: 7:OOAM PAGE: 13 SITE ADDRESS: 16588) SW 85TH AVE CLASS OF WORK: SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: CLEAN WATER SERVICES DESCRIPTION: Installing 500 ft. of water service and (2) backflow preventers. OWNER: CLEAN WATER SERVICES, PHONE #: 503 -6813500 CONTRACTOR: NORTHWEST EARTHMOVERS INC PHONE #: 603- 625.3100 Inspection Request Scheduled For: Date: 8/29/20013 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 074875 -01 503-849-8540 Y Corrections /Comments /Instructions: L4 ce r ik o JJ T C0/-idt �A�1 � c �� t� L A " S 4 a bid. `fio g I d S 5-,-e. /3511. T ht- y9peli rt. 0\t -nV 1 A/4+'ial..) D F w w � �pi� �e�.,�t � ( Pro AR_ Oa c z D 0.10,.1 t ) ❑ PASS PARTIAL APPROVAL CANCEL n NO ACCESS I 1 FAIL — CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED Inspector: 1 11.n,.a,)b....e. Date: g) ?a 1(4 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: I ?t 2008.00351 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/26 12.008 Phone: (503) 639 -4171 ;j1lA. Inspection Requests (24 Hrs.): (503) 639 -4175 r INSPECTION WORKSHEET FOR DATE: 10/8/2008 TIME: 7:ty0AM PAGE: t SITE ADDRESS: 16 SW 85TH AVE CLASS OF WORK: SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: 'LEAN WATER SERVICES DESCRIPTION: Installing 500 ff.. of water servi and (2) backfiow prevent els. OWNER: CLEAN WATER SERVICES, PHONE #: 603 CONTRACTOR: NORTHWEST EAR rHMOVERS INC PHONE #: 6o:3 621-;1100 Inspection Request.Scheduled For: Date: 1002008 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 07636 -01 603-t319 -6540 N Corrections /Comments/ Instructions: R. 0, c� cc. f ) L.-J-444 PLA) PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: f 1 Date: 1 0 (Q 1 OF) Phone #: (503) 718- r 2 5090 ❑ NEW ea PN W S -A W W A ❑ EXISTING BACKFLOW ASSEMBLY TEST REPORT ❑ REMOVED PROPERTY ❑ REPLACEMENT OWNER: C . C. LEAP/ WATER . �/ p VI C. E PHONE: ( ?i - 36 -)Ce) MAILING ADDRESS: / (p- _Cirg2) ..,c0/ p.c. 77-/ AYE !c' !� CITY 7 (-„/-AR (-„/-AR 1) STATEL-' ZIP 7 / 7. 2 .).4' ASSEMBLY _ ADDRESS: ASSEMBLY , ti STREET 4 R.P.B.A. ❑ D.C.V.A. ❑ R.P.D.A. ❑ D.C.D.A. ❑ P.V.B.A. ❑ S.V,B.A. ❑ A.V.B. ❑ AIR GAP SIZE: 1 4 1.141 MAKE: W/LKrA/ MODEL: ,37 --N WATER SERIAL PURVEYOR: CJry o 7&4/2 f) NUMBER: / 1 ASSEMBLY LOCATION: Ae0VE GRQQA'P 3 w Or Pf 1.7xi\/iV 1?1L& REDUCED PRESSURE ASSEMBLY P.V.B.A. / S.V.B.A INITIAL TEST AI CHECK �. A I.,L7C)UBE..CHECK:� AIR CHECK PASSED 12-- PRESS DROP i I ) 1 CHECK Itl INLET FAILED ❑ INITIAL RELIEF VALVE OP 3 . C ( B)ITIGHT DATE: ENE() Al , OPE NED A'f: ➢RF;SS DROP TEST MIN 2 PSID PSID • RESULTS 1LEAKED ❑ - 7 1(7/ C') BUFFER � ;_ � PSID PSID / A•B = f I CHECK k2 MIN J PSI DID NOT FAILED SYSTEM RELIEF VALVE I flGi( "I' Er DID OPEN ❑ ❑ PSI . f / PASS PASS W FAIL El ILEAKED ❑ "' COMMENTS Nw c.e)":<;'rgoc'; / 0vA oar 5S AVE REPAIRS AND /OR PARTS i I REDUCED PRESSURE ASSEMBLY P.V.B.A. /S.V.B.A. AFTER REPAIRS NI CHECK D.C;V. .:: PRESS DROP (A) :; - A DATE: TEST CHECK 41 RELIEF I OPENED AT PRI:SS DROP AFTER OPENED (B) TIGHT 0 PSID / / REPAIRS BFER „n UP• CHECK 42 A - B boa, tan ' TIGHT PSID PASSED ❑ ❑ PSI() PSID IN COMPLETING AND SUBMITTING THIS TEST REPORT, THE TESTER CERTIFIES THAT THE ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE wrrii ALL APPLICABLE RULES AND REGULAT OF 'DIE WATER SYSTEM. AND STATE REGULATIONS GAU AL.FB 1 ON DAT' (P./ / /05DEFECTOR METER READING - e.C .e--• 4 74 9 TESTER SIGNA' CERT (�G6NF1Z I�IE = W TESTERS NAME PRINTED / , [» 0 � ` S A 1 E . 1 a 5116 . 1 TESTERS ADDRESS - i ,r Y / �` PHONE M CL + � z1 , w,y7F !? s v$c COMPANY NAME - - 4i`" ' GYSE.R RESTORED REPORT RECEIVED BY .PR • A'iIVE: OF OWNER) WHITE • Water System Copy PINK • Customer Copy YELLOW • Tester Copy ❑NEW PN WS -AW W A ®EX►ST1NG BACKF'LOW ASSEMBLY TEST REPORT D REMOVED PROPERTY !Z VI ❑ REPLACEMENT OWNER: C L E [ A / ✓ � + 7 - 7 P Sr-!ZV1 C r~" 5 PHONE: ...)f' ,34 0(3 MAILING _ ADDRESS: / f,�sg c) ,5 VV gS"Thf 4 V e CITY T/ GA R0 STATE_ OR ZIP g72zg ASSEMBLY ADDRESS: .-5 AA /� _ STREET al R.P.B.A. ❑ D.C.V.A. 0 R.P.D.A. ❑ D.C.D.A. ❑ P.V.B.A. ❑ S.V.B.A. ❑ A.V.B. ❑ AIR GAP SIZE: 1 (91•LCID MAKE: MODEI ": ,3 7..1e WATER SERIAL PURVEYOR: C% 7i OI- 77Or //) NUMBER: XO 1 Z(c4- ASSEMBLY _ LOCATION: A /37 Y�' GiwVtiD S Vi 0 i= AI).N1 iV 1 i 1D1a REDUCED PRESSURE ASSEMBLY P.V.B.A. / S.V.B.A. INITIAL TEST PI CHECK .DODI3LE Cif ECK , AIR CHECK PASSED 9 PRESS DROP 9i. (A)1 CHECK #1 INLET FAILED ❑ INITIAL RELIEF VALVE B TIGH "f OPENED AT', PRESS DROP TEST OPENED Al � •: � ( �� DATE: MIN 2 PSID L.F "AKED ❑ PSID C ' c RESULTS BUFFER E R 5• i CHECK N2 PSID PSID /17 / 0 1 - MIN 3 PSI D ID NOT FAILED SYSTEM FIGHT g RELIEF VALVE py0 OPEN ❑ ❑ PSI / /0 PASS O FAIL ❑ 'LEAKED I-1 J COMMENTS � • E Y• C©,JT,Vc I / oN / 1 VL 0 1=-x15-TI )V, REPAIRS / AND /OR I� a PARTS REDUCED PRESSURE ASSEMBLY P.V.L3.A. /S.V.B. A. AFTER REPAIRS PI CHECK , 1 /C;V7Al` _ PRESS DROP:: DATE: TEST RELIEF (A) I CHEC,K 111 OPENED AT PRESS DROP AFTER OPENED (B) F IGHT ❑ PSID REPAIRS BUFFER ,•m I CHECK #2 A - B= - PASSED I TIf;J1T' PSID PASSED [] ❑ PSID PSID IN COMPLETING AND SUBMITTING THIS TEST REPORT, THE TESTER CERTIFIES THAT THE ASSEMBLY HAS BEEN TESTED AND MAINTAINED IN ACCORDANCE WITH ALL APPLICABLE RULES AND REGUI.AIlONS OF THE WATER SYSTEM, AND STATE REGULATIONS. GAUGE ��C "ION DATE k7 // '/C• /DETECTOR METER READING ,ESTIiN 51T; h(.. �`' 4Z `__. 1 7 q TESTT:RS NAM /: PRINTED b C2 S w g, A VC=- 5 ` b Q ) L TESTERS ADDRESS 4.. SS c E r4 ' vL V 'T (i V ' i T /°J�, , 5 y 6 / 0 / l.. PHONE P COMPANY NAME �/ E SERVICE RESTORED REPORT RECEIVED BY (REPRESENTATIVE OF OWNER) WHIR • Water System Copy PINK • Customer Copy YELLOW • Testa Copy CITY OF TIGAR® BUILDING DIVISION PERMIT #: PLM200E- 003!1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/26/2008 Phone: (503) 639 - 4171 11, Inspection Requests (24 Hrs.): (503) 639 -4175 �'�: "'I I INSPECTION WORKSHEET FOR DATE: 9/1620013 TIME: 7 :00AM PAGE:. 2 SITE ADDRESS: 16580 SW 85TH AVE: CLASS OF WORK: SUBDIVISION: SEWER 'TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: CLEAN VAIER SERVICES DESCRIPTION: Installing 500 fi. of warier service and (2) b ickflow preventers. OWNER: CLEAN WATER SERVICES, PHONE #: 503 -601 -3600 CONTRACTOR: NORTHWEST EARTHMOVERS INC PHONE #: 503- 625-3100 Inspection Request Scheduled For: Date: 9/15/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 076472 -01 503.849-8640 Y Corrections/Comments/Instructions: 1 A AA-r• i ,, roc.,,,., in PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS FAIL CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED Inspector: 6i\nn.A,J\\ \\ Date: l <1 OT Phone #: (503) 718- , CITY OF TIGARD .. BUILDING DIVISION PERMIT #: PLM2008-00351 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 806. Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 A- 14.: INSPECTION WORKSHEET FOR DATE: 919/2008 TIME: 7:00AM PAGE: SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK: SUBDIVISION: SEWER TREATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: CLEAN WA1 ER SERVICES DESCRIPTION: Installing 500 ft. of wate orvice and (2) bacglow prevonters. OWNER: CLEAN WATER SERVICES, PHONE #: 503-681-3600 CONTRACTOR: NORTHWEST EARTHMOVERS INC PHONE #: 503-625-3100 Inspection Request Scheduled For: Date: 9/9/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Watei service 075271-01 503 Corrections/Comments/Instructions: S-e. ( Co K p V e I (444-tpt....k" rz. ou-) 4- e tc-L, 1 -9 _s• .4cm-owe- Rev-La*" init-e4-) 7 PASS 1Z PARTIAL APPROVAL 7 CANCEL 1 I NO ACCESS FAIL 7 CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: (ra Date: 1 .11,6cn Phone #: (503) 718- CITY OF TIGARD " _. .. . , , 4,, BUILDING DIVISION PERMIT #: PI_M 20o8.00351 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/26/2008 Phone: (503) 639 -4171 ,I ,ail Inspection Requests (24 Hrs.): (503) 639 -4175 s "__.. INSPECTION WORKSHEET FOR DATE: 9/8/2008 TIME: 7:OOAM PAGE: 28 SITE ADDRESS: 16580 SW 85TH AVE CLASS OF WORK: SUBDIVISION: SEWER F F2E_ATMENT PLANT LOT #: TYPE OF USE: PROJECT NAME: CLEAN WATER, SERVICES DESCRIPTION: Installing 600 ft. of water s€rvic:e and (2) backflow preventers. OWNER: CLEAN WATER SERVICES, PHONE #: 503-681-3600 CONTRACTOR: NORTHWEST EARTHMOVERS INC PHONE #: 503 -626 -3100 Inspection Request Scheduled For: Date: 9/8/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 075193.01 503-705-5869 N 10:00 /4 04 Corrections /Comments /Instructions: , C ou rc.- l -1i.- - -61 1 O(Acd . Co ,, ✓• n PASS % PARTIAL APPROVAL n CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ,OrOr..n� \ \I 1+. Date: 9 1 O`1 Phone #: (503) 718-