Permit CITY OF TIGARD PLUMBING PERMIT
ffi COMMUNITY DEVELOPMENT Permit #: PLM2008-00426
13125 S H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/10/2008
T i G ARI? Parcel: 1 S 135CA00600
Jurisdiction: TIG
Site address: ,1120_0 SW_GREENBURG RD OFC
Subdivision: Lot:
Project: AUTUMN OAKS APARTMENTS
Project Description: Replace 200' of storm sewer service and (2) catch basins. 5/29/09, adding 800' storm line, (8)
catch basin, (5) manholes & (7) rain drain connectors.
Owner: FEES
AUTUMN OAKS PROPERTIES LLC Quantity Description Date Amount
6036 SW MADISON ST
PORTLAND, OR 97201 1 [PLUMB] Permit Fee 11/10/2008 $134.60
PHONE: 1 [TAX] 12% State 11/10/2008 $16.15
Surcharge
8 ea Catch Basin or Area Drain 05/29/2009 $132.80
Contractor: 5 ea Manholes 05/29/2009 $83.00
SHANNON CONTRACTING 7 ea Rain Drain Connector 05/29/2009 $116.20
2065 NW MILLER RD #415 800 If Storm and Rain Drain 05/29/2009 $379.80
PORTLAND, OR 97229 1 12% State Surcharge - 05/29/2009 $85.42
Plumbing
PHONE: 503 - 913 -1339
FAX:
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp: R1
Stories:
Total $947.97
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 1 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopte y the Ore.o
Utility Notific. n Center - .Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtai cop .
or direct q - stions to OUNC'by calling 503.246.6699 or 1.800.332.2344. •
Issued B Permittee Signature: 1
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
Site Utilities - • FOR OFFICE USE ONLY
City of Tigard Received ' Date/By: Permit No.: �. Ji �y t (� �� /y �
II
r: v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review rz`"� O �L/
Phone: 503.639.4171 Fax: 503.598.1960 Date /By. Other Permit No.:
T I G A RD Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
- . TYPE OF,: WORK . . ' FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description Qty. I Ea. Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
' , .CATEGO RY O CONSTRUCTION ' SFR (1) bath 249.20
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building 1=1 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
.JOB ,SITE "INFORMATION, AND .LOCATION - Site utilities
Job site address: /./zoo SW mad 4 leaf Catch basin or area drain g 16.60
City/State /ZIP: I t U 7222 v Drywell, leach line, or trench drain 16.60
j I Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: Project ame:
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16 60
Rain drain connector 17 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: _) 80 Page 2
Subdivision: Lot no.: Water service (no. linear ft.: _) ' I Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
- DESCRIPTION OF, WRK O Backflow preventer Page 2
0 l a t. C. p 2 v-- 2 b E 1 (0 Backwater valve 16.60
r 1L //�� 1 l Clothes washer 16.60
{�
Dishwasher 16.60
- .. Drinking fountain 16.60
❑ PROPERTY OWNER ., , I : , , ❑ 'TENANT , . -. .
Ejectors /sump 16.60
Name: Al� M�J 7 I.L. I Expansion tank 16.60
Address: ( 1 2 f . r) g , e nz . i + 1.01 Fixture /sewer cap 16.60
City/State/ZIP:
7 0 �n3� ` / On/ ci , � Floor drain /floor sink/hub 16.60
Phone: ( Sb3 ) Fax: ( ) Garbage disposal 16.60
APPLICANT Hose bib 16.60
❑
❑_CONTACT'PERSON
Ice maker 16.60
Business name:
� a Interceptor /grease trap 16.60
Contact name: 9nr' /G c;di(, Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( ) Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail:
Urinal 16.60
CONTRACTOR , . Water closet 16.60
Business name: eihtivtiNI (427 C"-:,. Water heater 16.60
Address: 2t ,w Mr /LIZ i ?,� Other:
' ` Subtotal
City /State /ZIP: ":4,1704 / o4� G N 724
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: /57y 1 7 Plumbing Lic. no.: P C ( 7 Plan review (25% of permit fee)
State surcharge (12% of permit fee)
Authorized signature:x
, ll AMY- TOTAL PERMIT FEE
_
Print name: N Date: 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.
I: \ Building \Permits\PLMU- PermitApp.doc 12/27/06 440- 4616T(t0/02 /COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su ppression Systems:
F,be ea Total
Sife�Utilities" - . . .., .-. "Q�`.•. - _, � >>� -„ • >S.quar`e�Footage: � - : ;,Permit >,Fee:
Footing drain - Is' 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 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40 .v ,
h
Va ation: : Permit Peer ' -
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
Fixture or Item. Qty: �, "Fee (ea), Total' additional $100.00 or fraction thereof, to and
1
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $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
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Commercial Fixture Work: :Plari'Itevie
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.
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\PLMU - PermitApp.doc 2
'y
CITY OF TIGARD PLUMBING PERMIT
i
1 COMMUNITY DEVELOPMENT PERMIT #: PLM2008 - 00426
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/10/2008
PARCEL: 1 S135CA -00600
SITE ADDRESS: 11200 SW GREENBURG RD OFC ZONING: R -12
SUBDIVISION: AUTUMN OAKS APARTMENTS LOT: 001 JURISDICTION: TIG
PROJECT: AUTUMN OAKS APARTMENTS
Project Description: Replace 200' of storm sewer service and (2) catch basins.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 2
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 200 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
AUTUMN OAKS PROPERTIES LLC
6036 SW MADISON ST Description Date Amount
PORTLAND, OR 97201 [PLUMB] Permit Fee 11/10/200E $134.60
[TAX] 12% State Surch 11/10/200E $16.15
Phone : Total $150.75
Contractor:
SHANNON CONTRACTING
2065 NW MILLER RD #415
PORTLAND, OR 97229 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503 -913 -1339
Reg #: LIC 159498
PLM PB619
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 rul r i •uestions to OUNC by calling 503.246.6699 or 1.800.332.2344.
"S , ..
Issu d By: K • 6 4 ■ 0 Permittee Signature: _e_e (e. to--
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.
..' ' • 1/4 't
' FROh1 4 : FAX NO. :5035319340 Oc 24 2008 12 : 56PM P2
Plumbing Permit Application
Site Utilities . 1 ()VFW .: l!`.4.; ON IV .
City of Tigard Rouivod
7
Dritc/BY i=r i .0U
__. iii 13125 SW Hall Blvd., Tigard, OR 97223
II MMII.r r .0' ; - 00
' , U , • Phone.: 503.639.1171 Fax: 503. Plea Review 598.1 Other Permit Nn :
DatcfEty
I I., p. t. ., Inspection Line: 501.639.4175 . .. . .
Ditto Roady/fly,
illiCRICI . www.tigard-or. gov Nntifiod/Moillatl: 1 / • , j z kr
S
jUIPPIWIRM.liV . ',1
0 New construction EI Demolition _........ Vur special lulermation use checklist
Description I Oty. I Ea. I Total
0 Addition/alteratino/replacement rig Other: Opp Ottie./-1 h/A/0 50■94P - New - 1: 2-family dwellings (includes 100 It. trench utility connection)
f„ . err ,„ ,, ,
- iai45Nizzl,rmai'it:F±P 4 ',;i; or , ■ ■,) valli 249 20
0 1 - and 2-family dwelling CI Commercial/inch PI trial SFR (2) bath 350.00
.. -- - •
0 Aecc 0 smory building Multi-flintily srR (3) bath 349,00
Each additional hurh/kiichcii 45.00
El Master hullder Tin Other $10 f tgrfki a0/346". --:: -- .
Hie sprinkler ( sq. ft.) Page 2
11100161212i#10110i001001 " '„
., i ■ .. 4 ,r . ., , , ,.1 ,..,. .,i6r. e:, i! , ii,,. • -.1, 1, ■2',:# .aNt:ingeF.: Site utilities
Joh site inithess: //200 i.t) 4ieersiiielloe4; de.fi Catch hnsin or area drain .; 16.60 3,5
, • „
City/Statc/ZIP: _
ji4)9eie)21 q/A2- 3 rywell le
. ach line or trench drum
16,60
........_ .
-
Footing dm
Suitc/b1c1g./apt. no,: Project narnc: Ail ra 1 - i AI vA Poe 4 posernerara in (no. linear IV: Page 2
. • • • " mimmilcuticil home, militia 110.00
Cross street/directions (4)1) site: 6 g per# ,74.0 4 ,-,,e,ve.,0eue 6 2
Manholes 16 60
. . „„... , .,., . ,. . ....
7 6 4 e 4 / i e w p s r - / i r o A/ ., 41.41r:f ...,#.40 _rlowe,73,./4'4./ Rain dr nn
ain coector 16.60 _ _
.......,,. „........
ieirr o4' re -1 .7 , 1 ,- _, - /Z 5r agter0/1914/ Sanitary sewer (no. linear tt.: . 1 Page 2
' J
Storm Sauer (no Imeur fl.: 240 P n g e 2
............_ ______ .
Subdivision - F ,,, , . ..........
Water service (no. lincnr 0.: ) Page 2 I
: „.„,„
, _. Fixture or Item
Tax mitp/pnrcel no.; / .5/ 3 CC itipoi.ovf, Ahmrp Lion valve 16,60
11;'ma ----..._
, kackflow ',levant:1 Puge 2
, ,p,,,z) ;,,,- BACkwracr valve 16.60
_._...„ __.
..sfilitt•M "fideV /01/ etC/P ale.. .5.,..-,9,4,-„ , Clothes washer _16.60
Dishwasher 16,60
77, 17,73p, o D!'"kirig ruuntii 16.60 -- _
Iiiiiitlik&ili a.: . 4 /i.: w ... 0. ,,,,, ..,■;;;MTWilrZkiiilillilgiR4:1■64Nilikg:' ...1!01. '. 6woronnip 16 60
Nome: /.//94/ 4 ,,,#.1./e.;, 54,,,„c ExpansiOn tank 16.60
,..,
Address: 6,0 s6 s do fv1A 6.1 , Fixturescwer cap 16.60
.. , .......... ....___
City/State/ZIP: ArevZ., „.9Air,9„ s , Floor druth/floor s _.
ink/hub 16.60
... . -
Phone: ( ) Fax: ( ) Garbage disposal 16.60
1411.71,111:MiltOlYlertiNiiiKkniitiMni:!!■1!q.M1 liAlThyylViVir,ifillillikkiiiiien-::7417.. _ 110.6 huh 16.60
___........__
p. .,2..r::!/,..:1;tilm..11n,zio,r..11; ■.,,A7■NA,, ice maker
16.60
Business name ..,&,i/vNeid er i.c
intcro m
loti trap
16.60 __.,..., ...„
I. name: /4_9(//,‘. .5,9tAvv,voil _..
Medical gas (value! $ ) Page 2
--•----- .
Address: 2-o 4 - AA( 44ibier p is /_/. / s- Primer 16.60
.--. . ...
City/Stale/ZIP: pogri.ih , 0 elliZr Roof drain (coninierc ion
......... ........... 16.60
- - Siolabaktrilluvutory 16.60 - Phone: 6..-.3 ) 9/3- /37 Fax. : ( go3) 6 0 -- 5 g
11lb/shower/shower pan 16,60
E-mail: xsA ,44:0,114 e "0.f/7 ., ,CDN7 Urinal 16,60
l A W° lltt r ii r et0g(TP 'I qPV W 6 W
A ' W1 1 "Wcrclj's; .
' - ' y.1111thlIWLW,L1 111 ''... 1 ' d ' , , l,lA , l, 1.a4i lasi.44+.tv,,,,i„i,. 10
-
6,6
Rusiness mune: ?,11.-4- id n Water heater 16.60
......
.0
Adiss
2(41r_MileA i t g/*- ,-, Other,
, Subtotal
City/State/ZIP: 0 _Tom • ; 4 .11 2q /
Minimum permit tee: $ i j4,
Phone: (5D3) 9r- - Fax: (( ,...0) . Pb& Residential Oa lalow minimum permit fee: S36.25
CCD Lie.: /S?/ 2' _ umbini.; I . ' • n : .... st , Plan review (23% of permit toe) se-
Authorized :aignature ------ . F -- I
..,
: to smeltery (12% of permit fee) tep. I
:
TOTAL PF.R MIT 1 /50 • 7
Print name: 7716/ A Al of l Duie: 42 - 29-746 This permit application csm Ka permit Is not °Wilma WIIIII II
ISO days after It li AS been accepted as complete.
•1-co methodology set by In Building Indahtry Service Board,
1,1•1111111100.011iiiinPI.M1 I-06. mil AN, oor.. V2177106 440.4616 T( 10/02/C OMANGD )
' FROM : FAX NO. :5035319340 Oct. 24 2006 12:57PM P3
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire S
,. .,. . ,. .:.. ..: ..: -: : -, , :: •'r ,:;. , � 7 . � l P''i "! "'� Su , re s ' t 6;, i� :,Ilf'E(i'i;:.;�;,r ' �) -•
dl.ntla S ression stems:
pp
F, i al ai " d r L • ' N (l i } i l } I, a It � �) X',
,i' r li:�,• 1•i� o :,;I ' 1 ,n.rti ,) :�.kil . t1 ■ f . ' , II1 I� , I: .., , 1
�,• a ' . L cu r,t..y6
r � � I� ?f �1�`.: n ..,. I f a � � r � , l) i i � � ;,, ;�, P ' • � . f i�f, i h
. .GL
Footingdrnin - I" 100' 55.00 0to2,000 _ $11500
. to Footing drain - each additional 100' 40.40 2,0(11 to o 3,600 11(10 0 0
— 1,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7201 and greater $309.00
Sewer • each additional 100' 46,49 •
Water Service - 1st 160' 55 00 Medical Gas Systems:
Water Service - each additional 100' 46.40 fir,• A ,u»r *r.•r•'rc" '� J �p� „ ar,Y,'r' "j kt r i•;; ,a arm:
• 'a d(i 1it�igliii � f�� i �' ice !I�fITY040— ; r tar l itl�{t ln' , liar r l l t r
Storm & Rain Drain - 1st 100' 55 00
i'.� $1.00 100 to $5,000 UO Minimum fee $72.50
Storm it Rain Drain • each additional 100' 1 # 0 40.4(1 55.001.0010 $10,000.00 $72.50 f vr the first $5.000.00 and $1.52 for each
U ""1 "1PU : !will : 7 iLl" ii,l. iiiil •;,; nt r'l �t= r � ;,! ii 6. additinnnl $100.00 or fraction thereof, to and
1 1;,,: ni'FS li' t , + t i ,a.,oll it, LI ' .':n'iC . . ,t
f
Commercial W Ba ` i l [y ,
i , i l Back kI to i ;.l::.. �! . "' . 4,,;'l e I ` � � d . . " 'I' " `t!' "d i $10,001 00 to $25,000,00 5 148.50 for the first y` , '`''. r � i k T'low Prevention Device 16.4u � n1.., archarting'�IOt00� -- Col t $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or traction thereof, to
(minimum permit fee $36.25) 27.55 - and including 525.000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $179 50 for the first $25,000.00 and $1 45 for
each additional $100.00 ur fraction thereof. to
inspection of existing plumbing or anal including $50.000.00,
specially requested inspections - per haul 72.50 $511001.00 and iv $742,00 for the first. $511,(1(10.00 and $1 20 tea
Subtotal' sash additional 5100.00 or traction thereof.
Commercial Fixture Work: '"'':, " -; �, , � i4 r l r' .P�1,4%1 I :� • i i, x a p'a !.W.; : e"".': ' , .'' '
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.
accurate) report fixtures could result in increased sewer fees * . ❑ Any new commercial building with water' service 2" and
mil li a jt;h I , , ui ., " :;" , ' .1.:; . '' 7���, 'flllrti�l �`tl"}°1'i�; 'nl'avi1 �`tl`'.° greater, except systems designed and stamped by licensed
f I I Pitt ,�,: engineer.
g. r .: 1 a S . i ": '.J l ,a t i,.J a �, ri "rfiit,, , 1 (;
,, ...i g .1�t „ r, , •r ',' 1 , : • f WS;, .,, I i I 4,,;.j."' tt:1: �", ;' ;tit! AtaAVik, ❑ New exterior plumbing site utilities for any complex structure
Daptisuy /Pont as defined in OAR918. 780 -0040.
Bath - Tuh/Shower _ ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool - ❑ Any multipurpose fire sprinkler system.
Cat Wash -Hach Stall ❑ Any complex structure o defined in UAI018- 780-0040.
- Drive 'I'hru
Cuspidor /Water Aspirator _ Submit 2 sets of plans with any of the above.
Dishwasher - Commercial
Damestic "ii;.;`J"" `�i+,'d a, !ij{i
I sometr i c or riser d agr qurrcd 1 lur � new building
(kinking Fountain „ ! It
Eye Wash r
Hour Drain /sink - 2» that mccl the qualificati0ns above.
-3 „
4"
C'ar Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal -Commercial
- industrial
Ice Mach. /Retrig. Drains -
Oil Separator (Sias Station) - .
Rea Vehicle Dump Station
Shower -Citing .
-Sinll
sink -Bar/Lavatory
- Bradley *Nate: if the fixture work under this permit results in an
-Commercial increase of sewer EDUs, a sewer permit will he issued and
- service Pees assessed for the sewer increase must be paid before the
Swimming Pool Filter _ plumbing permit can he issued.
Washer - Clotho.. I
Wa aoi Extractor
Water Closet • Toilet
urinal
Other Fixtures! .
http: / /www,ci,tigard.or.us /city hall /depiirhilents /cd /does /PLMU- Pernti$ doe
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL*Zool•coq Z6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 i Elul
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6 • Z5 , 0 TIME: PAGE:
SITE ADDRESS: I) ZOO CritAWBOY43 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 41 701 Pour Time:
Code # Inspection Description Confirm # Contact # Message
3 '40 Ilaum
Corrections /Comments/ Instructions:
Niis Z. IlAQ■ Sb
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r w Date: J2 Phone #: (503) 718- 1110
CITY OF TIGARD
BUILDING DIVISION PERMIT #:P ita,oid,• 0041k
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: 503 639 -4171
Phone: ( 503)
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: �,' Z� . �� TIME: PAGE:
SITE ADDRESS: ‘\Z, 6 1 1' ‘130 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: v t t Y Y V t v 4(5, ,
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: (1 74 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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399 Plumbing final 11200 SW GREENBURG RD CFC PLM2008 -0045
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06116/2009 12:05 533
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320 Plumbing rough - in 11200 SW GREENBURG RD OFC PLM2009 - 00150 —
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06/17/2009 05:06 503 -913 -1339
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1 002831 - 01 503 - 913 - 1339
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30 Storm drain 11200 SW GREENEURG RD OFC PLM2008-00426
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Inspection Date Inspection Time Result Department Inspector
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112 3034 from WQ manhole North to existing catch basin is approved for cover pending tracer wire arm fully grouting —
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— Inspected by Rich from Clair Company
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340 Stern] drain 11200 SW GREENEURG RD OFC PLM2008-00.=26
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06/18/2009 03:02 PART Euilding Dan Nelsen
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