Permit CITY OF TIGARD
A -
DEVELOPMENT SERVICES PLUMBING PERMIT
PERMIT #: PLM2006 -00137
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 DATE ISSUED: 4/14/2006
PARCEL: 2S 101 AD -01400
SITE ADDRESS: 12700 SW 68TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 033 JURISDICTION: TIG
Project Description: Add dishwasher, 1 sink and hose bibb. Relocate drinking fountain and 1 sink
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Owner: FEES
OREGON KI SOCIETY
12700 SW 68TH AVE Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 4/14/2006 $83.00
[TAX] 8% State Surcha 4/14/2006 $6.64
Phone : Total $89.64
Contractor:
NW PLUMBING SYSTEMS LLC
PO BPX 68246
PORTLAND, OR 97268 REQUIRED ITEMS AND REPORTS
Contact # : FAX 50- 786 -3722
PRI 503- 307 -2332
Reg #:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By 4 . a ,„ Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
APR -13 -2006 11:24 AM P. 01
Apr ]2 OG 11s134 T °w' Eet VF 503 -777 -0472 p.4
Building Fixtures 9.- 1/O ( A-0 '-04o0
APR 1 4 .10 06
Plwnbinu Permit A►oulicatio , , ,: "III, , . , , 1 ,
city of 1a CITY OF !& j j 91 9 P/ o& ,66 nnedtN: 17 -6'°/ a 7 .
• I S 13S TIF Blvd, T
Phase; S03.639.4111 Po 4 kaT1 V T(; �(1y � / � OM 1 1 ° rw *ha Rona o
. Inspection u,.: 503.639.4173 a � 6 -.4 i
letmsa: waw.HUed. ,.go• � Q d e O Ih.ti.p �
TYPE OF bvRK , TIP - •.
❑ New co guvgtlon ❑ Demolition Forsook hilbeesetion we efiedfin
,j ndditioNaheration/ropincement ❑Other: Deswlptiott 1 9tr. 1 Eel Taal
New 1- 24•mtly dwenings (Includes 100 Q for (*Motility mm+ectlan)
_ CATEGORY OF CON$TRUCI ION MFR (1) bath 24920
❑ 1- and 2 -41pmfy dwelling ❑ Commercial/industrial SFR (2) bulb 350.00
' Accessary toenails O Multi -family SPR (!)bath 399.00
- �- Each additional b.th/citdmo 41.00
❑ Master Mader ❑ Other:
JOB g1TZ INFORMATION *24D L+bCATLON Pia sprlakkt ( ,_ ,, s4 A.) p 2
, She Millais
Job site addratl: 1 L - (9azzi_ !Lev Gosh bale or Brea drain 16.60
City/State/ZIP: -�� 7 Q � 17 22_3 Drywall. lamb lino, or french drain 16.60
Suite/bldg./opt. no.: 1 Project name: K475/11-6 ei,..-4 Footing dram (no. Omer R: ^) Page 2
Cross street/directions co Joh site: .LjL3sy1n
/ Al , bk Nt.oatllcNted botee thinks 110.00
A T�'Jf�� �� Manholes 16.60
t" 3 N I Rain drab, stmt 16.60
Subdivision: r I Lot no.:
Sanitary sewer (no. Emu A.:... ) Pag.2
Storm sewn (m Sneer e.: _) 2
Weer service (no. Irntsar A: Paget
Tax maprpu� no.: Flame or Item I � I
DettaurnON OF woRi valve 16,60
��11 l rye � j , �I y ' L �� y Backrow prewswer Page
Ir)DiTy'/J 7 4 Sit/ 6011
/ �� aL 0
s� �� � r a 1 Bo rnlve 16.60
��C�lTrs/ "fi) Sl .izzeti v� f i/tit. J awns warm 16.66 ,
Dishwasher # 16.60
0 PROPERTY OWNER i 0 TENANT
Drinking Rnnr•in 1 16.60
Name: ad :4.�.��Yr '-1 �1t+aor6BrlmP 16.6•
Expansion Rink 1660
�Addrtsa: �. Fixate/me cap 1660
City/Slata/ZIP; Floor drain/floor aids/hub 16,60
Phone: ( ) Pax: ( ) clabaj a disposal 16.60
0 APPLICANT 'CON rAc? PERSON ,Hose 16.60
hueittess name: /i(H/'./44„4 P /,�11,.., syik. 15 4.44 lee
16.60
, Interceptor/grease trap Coma:d nwne: A4 f 7o z / '
! MetkalOa(vanit$ ) Pege2
Address: e_ o. 68 Lt/b Prim ; 16.60
City/9tille/TIP: o rf ok . ' 268 Roof drain (ce.nmaeial) 16.60
Phone (50 ) of - Z33.4 Fax: :1507) 786 - 71 Z , t9ink/bBrinnevatory � 1660
Frnlad: M 0C/frog, , 6. t4 , a y Tub/shower/shower pas 16b0
Urinal 16.60
CONTRACTOR wam dome - 16.60
Business name: Fp UJ - 7' ` i _c . ..c MIMEO Wow Mater 16.60
r _ i Other: L4 C J 1
City/State/21P; or-/-41.4. t9,e ot 7 a l4s btob r permit Om G
Phony ( ) 3077 7.332 Fax; ( 3 7,r Z- R.aident� b.eh*ow mainsail patois S72.30 D / z .W
t C& Lic: Ni - 73 / f 9 *7 i=523=1110ZIMI Pan review (u%orppmit tbel
., Suit 4i,
r me: ���
Authorized 9igoat - / �Jfo � AL PERMIT PET , ma
4 ' z .. Data: y - Z -`6 Tbli permit appU catN4 mate if W. penult h nel obt•1•ed within 111 complete,.
ISO *Fee a cmodoleg � Seen
TrI -Cw mty Duman Watery *mice Board
,. r 4 w-winounp.ein rweaoe W04atouismeOwwenl
e
Received Time Apr.13. 1:01PM •
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM200600137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4114/2006
Phone: (503) 639 -4171 4topo
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/10/2006 TIME: 7:04AM PAGE: 3
SITE ADDRESS: 1 1700 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 033 TYPE OF USE:
PROJECT NAME: OREGON KI SOCIETY
DESCRIPTION: Add dishwasher, 1 sink and hose bibb. Relocate drinking fountain and 1 sink
OWNER: OREGON KI SOCIETY, PHONE #:
CONTRACTOR: NORTHWEST PLUMBING SYSTEMS, LLC PHONE #: 503.307 -2332
Inspection Request Scheduled For: Date: 8/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 034746.03 503-318-6632 Y
Corrections /Comments / Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /h ) ;, e" Date Phone #: (503) 718- --114
CITY OFTIGARD
BUILDING DIVISION '. PERMIT #: PLM2006-00137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4114/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 iv I'
_
INSPECTION WORKSHEET FOR DATE: 6/22/2006 TIME: 7:01AM PAGE: 4
SITE ADDRESS: 12700 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 033 TYPE OF USE:
PROJECT NAME: OREGON KI SOCIETY
DESCRIPTION: Add dishwasher, 1 sink and hose bibb. Relocate drinking fountain and 1 sink
OWNER: OREGON KI SOCIETY, PHONE #:
CONTRACTOR: NORTHWEST PLUMBING SYSTEMS, LLC PHONE #: 503.307 -2332
Inspection Request Scheduled For: Date: 6/2212006 Pour Time:
Code # Inspection Description Confirm # C t Message
399 Plumbing final 032179 -04 503 -318 -6632 Y
Corrections /Comments /Instructions: //d P 6 — ):06
/. /I M W/ a
i
'
/
❑ PASS 4/i, PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I 1 P hone #: 503 y.ey 0 Date: / � ( ) 718-
' CITY OF TIGARD
BUILDING DIVISION - PERMIT #: PLM200S-001:a7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4114/200 6
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/18/2006 TIME: 7 :01AM PAGE: 2 i
SITE ADDRESS: 12700 SW f ib TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 033 TYPE OF USE:
PROJECT NAME: OREGON KI SOCIETY
DESCRIPTION: Add dishwasher, 1 sink and hose bibb. Relocate drinking fountain and 1 sink
OWNER: OREGON KI SOCIETY, PHONE #:
CONTRACTOR: NORTHWEST PLUMt3ING SYSTEMS, LLC PHONE #: 603307 -2332
Inspection Request Scheduled For: Date: 5/18/2006 Pour Time:
Code # Inspection Description Confirm # Co. Message
33( Rain drain 030122 -01 503-31(3-6632 Y
Corrections /Comments /Instructions:
•
11, SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: h � Date: )/( Phone #: (503) 718-
l v
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: PLM 20066.00137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/14/200
Phone: (503) 639 -4171 �,,�11I�I
Inspection Requests (24 Hrs.): (503) 639 -4175 ...:�"� `:_..
INSPECTION WORKSHEET FOR DATE: 5/16/2006 TIME: 7:02AM PAGE: 23
SITE ADDRESS: 12.700 SW G8TH AVE. CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 033 TYPE OF USE:
PROJECT NAME: OREGON KI SOCIETY
DESCRIPTION: Add dishwasher, 1 sink and hos7e bibb. Relocate drinking fountain and 1 sink
OWNER: OREGON KI SOCIETY, PHONE #:
CONTRACTOR: NORTHWEST PLUMBING SYSTEMS, LLC PHONE #: 503- 307 - 2332 •
Inspection Request Scheduled For: Date: 5/1E Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 029960-01 503-318-6632 Y
Corrections /Comments /Instructions: �/ \,
1P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /171/ / . . Date: / AO / Phone #: (503) 718-
,
CITY OF TIGARD
BUILDING DIVISION d '`-• PERMIT #: PLM2Q0G•0O1 17
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 4/1412.00:
Phone: (503) 639 -4171 I
44't 1 4
Inspection Requests (24 Hrs.): (503) 639 -4175 "'f L
INSPECTION WORKSHEET FOR DATE: 4117/2006 TIME: 7 :05AM PAGE: 25
SITE ADDRESS: 12700 SW 6171TH AVE CLASS OF WORK:
SUBDIVISION: WEST POR1 LAND HEIGHTS LOT #: 033 TYPE OF USE:
PROJECT NAME: OREGON KI SOCIEI Y
DESCRIPTION: Add dishwasher, 1 sink and hose Bibb. Relocate drinking fountain and 1 sink
OWNER: OREGON KI SOCIETY, PHONE #:
CONTRACTOR: NORTHWEST PLUMBI SYSTEMS, LLC PHONE #: 503.307 -2332
Inspection Request Scheduled For: Date: 4/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
316 Post /beam plumbing 020170-03 503 - 310.6632 Y
Corrections /Comments /Instructions: /
� j .
rb . •
3 v
iVo •)--ivg- ./Pr
(i rk(
' ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL
mi CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
l`` ` I �
2 �W
Inspector: / Date: / b P hone #: (503) 718- /