Permit .
C ITY OF TIGARD PLUMBING PERMIT
141A DEVELOPMENT SERVICES DATE P #: P /2005 M2004-00565
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15895 SW 72ND AVE BLDG B 250 PARCEL: 2S112DC -00500
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 040 JURISDICTION: TIG
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: 6 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Addition of (6) service sinks.
FEES
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI [PLUMB] Permit Fee 1/4/2005 $99.60
PORTLAND, OR 97224 [TAX] 8% State Surchar! 1/4/2005 $7.96
Total $107.56
Phone:
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP #3
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone : 503 Rough -in Insp
Final Inspection
Reg #: LIC 120893
PLM 34 -412PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR
952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)
246 -6699.
Issued By: Permittee Signature: 12/7 C
Cali (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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FCIR OFFICE: 1 r !)•;1.\
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399.90
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Page 2
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Page 2
110.00
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CIT OF TIG
gel VG DIV
Pumps ialLefornsdow sae dii:cetera
Doartvaon 1 Qty. 1 Es. 1 Total
New 1- 2damr y dwdUogs (mdudes 10011. ibr each u6llq cwrrccdon)
SFR (t) bath
SFR (2 ) both
SFR. (3) both
Fire spriakIev � sq. 11.)
Site
Wotr r oevim (so. knew it. .—..) poile2
Flown Or itsel
Absorption vdro 16.60
sockeye. prevenmr ftp2
aackw.ar valve 16.60
Disliumater
Milking fad
geetorsIsotrip
Equinsion teak
Fuomeesener cep
PhamdMWOomebohibub
Garbage disposal
Dom bib
lee maker
gaa
(w alum S
liformal
Prtnes
Roof drain (eonuaawt)
TubashoweitsbovierPW
tithed
Water closer
Wane imam
Sabtoul
Mi iuuim permit la: S7L5O
Residential baboon minimum permitfee: 516.2$
Plan teview use of permit fee)
Stele surebarge (S%oepcnn )
TOTALPERMI'T FEE
"Mk Yessat appliadeS aspires 1r a permit bt not obtained vdthln
/Warp alit bas been bccePted u 00tulgazt•
'Fee methodology set by Tn.' Clumsy goading industry Saul= some.
ypdae 1241
66996BZE0S
RECEIVED
DEC 2 2004
4464616nt6RUICCO I WSg)
-00 2utgwnid apeosej
d6I :21 b0 62 0aQ
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received 1 Date Requested ! — AM PM BUP
Location ` 5 R 7 a` �� Suite . MEC
Contact Person Ph ( ) _ PLM �U q --d O Slo
Contractor � Ph ( ) YSy SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: 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
9 /2/1'
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other
S 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date / Inspector �/ /7'� Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL