Permit C ITY OF TIGARD
PLUMBING PERMIT
�r. Tr DEVELOPMENT SERVICES PERMIT #: PLM2002 -00486
''' I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6 39 -4171 DATE ISSUED: 12/17/02
SITE ADDRESS: 09625 SW 69TH AVE PARCEL: 1 S125DA -06600
SUBDIVISION: KINGS VIEW ZONING: R-4.5
BLOCK: LOT: 052 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 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: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water service line.
FEES
Owner:
Description Date Amount
HOAGLAND, DEAN GUY AND ZOLA
9625 SW 69TH [PLUMB] Permit Fee 12/17/02 $72.50
TIGARD, OR 97223 [TAX] 8% State Tax 12/17/02 $5.80
Total $78.30
Phone :
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone : 503 771 - 9449 Water Line Insp
Final Inspection
Reg #: LIC 42671
PLM 34 -70PB
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.
-
Issued By: Afijj�,L Permittee Signature: eX/ eff-- 70
CaII (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
DEC -12 -2002 12:52 PM CROWN. PLUMBING 503 771 9454 P.01
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Address: •13125 SWRa11 Blvd. OR' 97223 ; ���f���� Sevl�etperinit oo. B ap ao,: _ "
Y(01gard . - . Phone: (503) 639 - 4171 . : 1 200 Fiaie tleppL ao.: Bxpuedam: ... .
Fax: (503) 59 &1960 2
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Land use approval' DUI ' C oe fila am:
• Payment ape:
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XI. & 2 randy dwelling ni i . ' CI ConrmerclalAndustria(_. -_._ " . O Mu1t}-family. O Tenant improvement .
O New oonsu ction Addition/aitelratitodteplacemeat ... 0 Food service' 0 Other: .. ° ,
Jou si 1 1': iiNi.o1111:1T10N 111 411 1)1.1,1: Om spc•ci.il iufurn)uliut use clmrkli,ll 1
Job address: (oohs Seri , q tiff, CII L.= C21 Total `
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SFR 1 bath.
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• . - • ' • i I ` . i _ . ) ` Catch basin/an:a drain
Est. date of oomphato fmspectivn I 7? I '3;71 m1 • < < :
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Owner installadontresidential maintenance only The actual installaeion- , •, t =
will be made by mo the maintenance and repair made by my regular Ip?• _ o •.. •t''•"T'*s^ P
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employee on the property I own as par ORS Chapter 447.. . 3 a . " 1? n b _
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Minimum fee »... ..... $ ')2 2
wads m000tmst
aashgoats i eam ex man iota N o ti ce: This permit application --
Mika GI �,. , : ` _ - expires if a permit is not obtained P18n rev iew (al _ %) $
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /c2 -/1 AM PM BUP
Location � a2 �D Suite ME
Contact Person Ph ( ) LM o� -" L itA
Contractor Ph ( ) '71/ ' 9 R
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
•
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab `�
Rough -In (
, a er Servic
- Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
.-PA PART FAIL
HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line r n ' - �
ADA Date ) Z1 \C) (� v Inspector 1 Y " } `L Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL