Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2003 -00145
�•��I,r DATE ISSUED: 4/16/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14640 SW 76TH AVE 066 PARCEL: 2S112BD 00100
SUBDIVISION: TIFFANY COURT APT. ZONING: R -12
BLOCK: LOT: 065 JURISDICTION: TIG
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:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace plumbing fixtures.
FEES
Owner:
Description Date Amount
WASHINGTON CO. HOUSING AUTHORITY [PLUMB] Permit Fee 4/16/03 $72.50
#200-L, 0 -L, MS63
111 NE LINCOLN ST [TAX] 8% State Tax 4/16/03 $5.80
HILLSBORO, OR 97124 - 3082 Total $78.30
Phone : 503 846 - 4794
Contractor:
BEAVERTON PLUMBING INC
13980 SW TUALATIN VALLEY HWY
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Rough -in Insp
Phone : 643 - 7619 Top -out Insp
Reg #: MET 00001047 Final Inspection
LIC 12889
PLM 34 -4PB
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 By: —/ / / �,�(/ Permittee Signature: (X,, // .I/
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the nd'xt business day
. , •
P'lutnbingPe rtitApplicati ®n 01..1:1( ' i ►.
f Date received:/ -f— G r Permit no. /, t j � G�l J J
� ' 1 T I . : City of Tigard t
:. ' , Address: 13125 SW Hall Blvd Tigard, O R 97223 Sewer permit no.: Building permit no
sl. , CI ty o ;; Phone: (503) 639 - 4171 g _
pp
z- f c ; k - 0 Pro'ecba I. no.: Expire date:
Fax (503) 598 - 1960 Date issued: By Receipt no.:
• 5 � ;1 ,, ; 5 { h _, use approval: Case file no.: Payment type: ..
y 1 ' '1'1,1 01 ' 1'I U'SI I f ;
w� 0.1p& fainll dwellw or accessory Commercial/ind „ � y , 4 Z 4 . Y , . ,, 5 g P „ rY, N ¥Multi-family 0 Tenant improvement
x.; ,•- y 4 4 i' ' 0 New:constructio 1. . .4 5;' Addition /alteration/replacement ❑ Food service CI Other:
�� )Olt tiI l 1' I \I \ I'IO\
r trtr t I I)l I.I (for u.c hc� .I)
GI'I..SC11 special inl'hrntatiort c LI i
1N `` .- , > '' Job address /'f� � SW 7 ( 14} 16 - Descri lion qty. Fee(ea.) Total
e /A, Bldg, ''no.: ' ' • Suite no.: New 1 -and 2- family dwellings only:
' ”" 'Tax map /tax lot/accottnt no.: (includes 100 R. for each utility connection)
w` SFR (1) bath
;° a. " Lot''" :h` Bl Subdivision:
SFR (2) bath —
y n
';:.� z 'Project
(ii t SFR (3) bath -
,, , '? lf ; Ci /coon Zip: Each additional bath/kitchen _
:,, ` " ' Descripti
: o and location of) prk on premises: Site utilities:
II
(', �. ,.r "'v ",� '1F k�6'yi�tv,.tf�
' 'x'' "� I�FP 4 yrun_F Catch basin /area drain
%'' ,r��� Est:date of completioWiiia , : lion: Drywalls /leach line /trench drain NM
a
Footing
P'� n r drain (no. lin. ft.)
l.t �I,IiI \(: ('l)\ 1Il \S'I`(Ilt, g MI
i Manufactured home utilities
, ' ' hither: - ' �/ -
t? 'a Buei
, Manhole
Vi ;, Address :` G :10, w
r , : , . ' s f: State r Sanitary sewer (no. lin. ft.) drain connector =
' :Vie-
�o �/'_ ZIP: Sani
.,:,. ' II erffien Fax: E -mail: Storm sewer (no. lin.
1 - , R; r : , . hone: , ft.) —
ME
r � ' "" CCB no.: �j Water service no. lin. ft.
' ,� Plum bu s . reg. no:
•, '. `>� Fixture or item: ■ -.
=. ,i i i ;, „ „r City/metro lie. no.:
s Abso twin valv
a a C repre sentative sj:a afore: � ME
if °Y ° , J� nv Back flow ter
i , t , Print Name ba t► c s Dat B ac k wa t er va mu
a ( ( 1 t( 1 1 ' 1 'I 0' INN Mil
Basins /lavatory
Nam Clothes washer MI
l � ��
F l Dishwasher
-_,. Address: '
r`' —
r,;;,` ; � / , :' , ., Drinking fountain(s) ZIP:
• - Ci ' Sttae:
1 i Phone e Ejectors/sump MI
' • .', ` ' F Ex
Fax E -mail: •
c , :;,u :. Expansion tank �
} l)1l \1 12 Fixture/sewer eap MI
a!a Name print : " ” Floor drains/floor sinks/hub NM
'" Mailing address: Garba:e dis I osal —
4 5,... gu ,, ,... , . Hose bib .
State: ZIP:
M '
I
: ^��`'�, Ct Ice maker r
a :.k`, . s Fax: E -mail: In terce ptor /grease trap
. Phone: ' F = __
. .. ';
: , > Owner. installation /residential maintenance only: The actual installation Primer(s)
f r; t will be made by me or the maintenan and repair made by my regular Roof drain (commercial) ME -
e on th property l own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
\(;1 \ I i It
? -. Own s I a to r D ate: Sum
v n ;n� _ BEI 1 4 ° , I• Tubs /shower /shower pan MAN
ME NOM
Name "'�d -,' U rinal
: � '^
I: �` Address:''`' Water closet B' �>i!�
Water
s > . heater
i R ,4 • C ity . . State: ZIP: Other:
t / Ph one 4 ._,' : ' Fax: E -mail: --
Y n mP � Total / �e �
;'45;:' N ot s ll uri;dictl Minimum fee $
P
j 'Meet meth) catch, please cap jurisdiction for more in formation. permit pp
w Notice: This U application o
1 * , ;. QM/404 D MasterCard ex ires if a Plan review (at _ /o) $
:s x <h Cre and number, p permit is not obtained a
°e / / State surcharge 8 /o .... $
•' , . Expires within 180 days after it has bee TOTAL g ( )
F k � 4k-- ,. do credit card accepted as complete.
Name of cardholder as shown $ � �
l;, : , -t } , Car signature Amount
440-4616 (6/00 /COM)
.'ttl ,per,
CITY OF TIG/ARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date. Requested AM PM BUP
Location / t ' '/n - 7(a Suite 6. MEC
Contact Person . Ph ( ) q PLM 3 —
Contractor Ph ( ) b q 3 76„ ! 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 ./0A-(//
Other: •
Final
PASS PART FAIL
PLUMBING
Post & Beam
7.0 / AP r- 41110'
h - �� - /1
ervice
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan /
a
u
'� • 'j 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 Ei Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 61,3 Inspector • Ext
Other:
Final DO NOT REMOVE this inspectio record from the job site.
/ \ PASS PART FAIL