Permit 4 �. -
C ITY OF TIGARD PLUMBING PERMIT
�i� DEVELOPMENT SERVICES PERMIT #: PLM2003 -00499
4 I I 131 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/23/03
SITE ADDRESS: 14140 SW 72ND AVE 100 PARCEL: 2S112AA -00900
SUBDIVISION: NELSON BUSINESS CENTER ZONING: I -H
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B 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: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Pump room: Install 1" backflow assembly to water supply.
FEES
Owner: Description Date Amount
SPIEKER PROPERTIES LP [PLUMB] Permit Fee 9/23/03 $72.50
4380 SW MACADAM AVE STE 100
PORTLAND, OR 97201 [TAX] 8% State Tax 9/23/03 $5.80
Total $78.30
Phone :
Contractor:
DP PLUMBING
904 S. CHEHALEM
NEWBERG, OR 97132 REQUIRED INSPECTIONS
P RP /Backflow Preventer
Phone : 503 - 537 - 9492
Final Inspection
Reg #: PLM 110612
LIC 36 -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
Issued B Permittee Signature: , /ow,* -
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
PlumbingPermitApplication
OI F I C E USE ONLY
Datereceived D Permitno.: L . p3- �0'� °. 11
' �ijj' City) f Tigard �� E' ewer ermitno.: Buildin emritno.:
' " Address :13125SWHalIBIvd,Tigard,OR97223 ��„ p 8p
Cityoffigard Phone:(503)639 -4171 SEP 2 3 Project/appl.no.: Expiredate:
Fax: (503)598 -1960 2003 Date issued: M Receiptno.:
Landuseapproval:
BU CITY OF TI f Casefileno.: Payment type:
ILDIN
❑ 1 &2familydwellingoraccessory ❑ Commercial /industrial 0 Multi- family 0 Tenantimprovement
❑ New construction GI-Addition/alteration/replacement 0 Foodservice 0 Other:
.1OBSITHN'FORMATION FE ESC! IEDU LE( forspecialinformatiu sechecklist)
Jobaddress: (4 14 0 SW 12 )' Description Qty. Fec(ea.) Total
Bldg.no.: Suiteno.:
Newl-and2-familydwellingsonly:
Taxmap /taxlot/accountno.: ( includes100ftdoreaclntilityconnection )
SFR(1)bath
Lot: Block: I Subdivision: SFR(2)bath
Projectname: U ( (,-r- SFR(3)bath
City /county: likrofti I ZIP: 1-zz44 Eachadditionalbath/kitchen
e ptionand locationofworkonpremises: Siteutilities:
u 1 N (pl t f ra TO 6 P . Catchbasin/areadrain
Est .dateofcompletion /i 1) (,l, M , V •Om Drywells /leachline /trenchdrain
1'LU 1∎161 NGCONTRACI'OR Footingdrain(no.lin.ft.)
Manufacturedhomeuti l ities
Businessname: P.". P b 1 J Manholes
Address: , 0 5 t _ Raindrainconnector
,(,�a(
City : K,Vlr( State: Or ZIP: 0 7113 Z- Sanitarysewer(no.lin.ft.)
Phone: ((// Fax: E -mail: Stormsewer(no.lin.ft.)
CCBno.: 1101 I Plumb.bus.reg.no: 3f9 - PS Waterservice(no.lin.ft.)
City/metrolic.no.: 00/ f Fixtureoritem:
Contractor 'srepresentativesignature: giyld. Absorption valve
Printname: Z i�.14 0,: wt� Date: /, Z5. # — Backflow ter 1 116.40 464C Backwatervalve
CONI'/ C7TERSON Basins /lavatory
Name:
Address: Do rri Clothes washer
- Dishwasher
City: I State: ZIP: Drinkingfountain(s)
Ejectors /sump
Phone: Q104 Fax: E -mail: Expansiontank
Fixture /sewercap
Name (print): ,r, P Floordrains /floorsinks/hub
Mailingaddress: �� / E , 4 (030 Garbagedisposal
Hosebibb
���
City: , fJ7 Icemaker
Phone: 2,46 t j Fax: E -mail: Interceptor /greasetrap
Owner installation /residential maintenance only: The actual installation Primer(s)
willbe madebymeorthe maintenanceandrepair madeby myregular Roofdrain(commercial)
employeeonthepropertyIown asperORSChapter447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Sump
EN G INFER Tubs /shower /showerpan
Urinal
Name:
Watercloset
Address: Waterheater
City: I State: I ZIP: Other:
Phone: Fax: E -mail: Total ,./
Notalljurisdictionsacceptcreditcatds, pleasecalljurisdictionformore information. Minimumfee $ 12
Notice: This permit application Planreview(at _ %) $
°Visa °MasterCard expires ifa permit is not obtained u
Creditcardnumber: / / within 180daysafterithasbeen Statesurcharge(8%) .... $ 5. B 0
Expires TOTAL $ em. 30
Nameofcardholderasshownoncreditcard accepted as complete.
$
Cardholder signature Amount 440-4616(6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested AM PM BUP
Location / ` L/Q 7.2' Ave_. . Suite / D o MEC
Contact Person �' 11 r- . Ph ( ) 609 2 - p-$Lf 3 - 4 b�99
Contractor po L `� X Ph ( ) SWR
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
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
PART FAIL
'fS
• ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final D Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 11 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date 4 1 Inspector Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
e SS PART FAIL