Permit CITY TIGARD PLUMBING PERMIT
I DEVELOPMENT SERVICES
PERMIT #: PLM2003 -00144
fl 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/16/03
SITE ADDRESS: 14640 SW 76TH AVE 062 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, 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
Phone : 643 7619 Rough -in Insp
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: 41IP , ��� Permittee Signature:` Q t . 4
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the nex business day
--- - -- . ___
. _
'' !':':. ,. ,
• .
. tti t.1(.., s ()\i i )
.. Plunitinn° g Permit Apphcation 1 t i _
. „.„.,„. .
1,4: • , . Date received:/1- 6.-t7 ,1 Permit no.: c)003-&1°/
.: " ' , , INIl l ,: , :.':::, City of Tigard
, . 0: :: , ,: .. ...11 441.• •• ' i '!,;;.: Sewer permit no.: Building permit no.:
...tv‘' ' ..; -- ?:',.; 13125 SW Hall Blvd, Tigard, OR 97223 '
.
City.ofTigard
Phone: (503) 639 Project/appl. no.: Expire date:
Fax (503) 598 Date issued: By :PP' Receipt no.:
': ( V(;', :4,/f.':," : Land u s e approval: . • Case file no.: Payment type:
,
1 111.1 01; PI:11,111T
614,5 .1-.1.tlit fk2 fiumly. &Veiling or accessory I:1 Commercial/industrial X.Multi-family 0 Tenant improvement
.04Vit "ki.i•lel;v"ConstructiotiVgiz 5- OtAdditionialterationireplacement 0 Food service 0 Other:
. • '.- ,
.1(nt SI 11 I N,l'ORNI 11; 0.■ ' . Ill M•111:1111.1. (for special inhirmalion the cliiA1:110)
" " .".
'Job addtess. /%q ,...5a, 76 ifitib° , ..4*-----63:a'-- Desert , tion Qty. Fee(ea) Total
• ...._
Bldeno New 1- and 2-family dwellings only:
140,p .: ' " • Suite no.: I, 2...„: ;
f..i...fiV . (includes 100 ft. for each utility connection)
Tax map/tax lot/accottnt no.: ---- ;
SFR (1) bath
N* • Loi1WY';''' ''' Block: " ' Subdivision: SFR (2) bath MI
Project name: ' t ' 'o (-CA- ' , 11 SFR (3) bath IMI
City/coun : ' " ZIP: Each additional bath/kitchen 111111
Desc : • tion and locatio • f work on • remises: Site utilities:
1111
_
-= Catch basin/area drain
Drywells/leach line/trench drain Mill
EsCdate Of compledon/iiis . tion:
. • Footing drain (no. lin. ft.) IIIII
I'l 1 1111(M; ( 0N:11( 1(:111It ,.
, _
. il,. , ;M,fr =uM!! . 0 - - Manufactured home utilities MI
LATT PP4AleSP time. :. 1 ..--arrianismum C , "—C. Manholes 111111
• Address:13 ' ' MLIELWE Rain drain connector MN
CRY:* k - State :Ca_ ZIP: # II. Sanitary sewer (no. lin. ft.) MI
".':',j4;■qi..
Phone : MEM Fax E Storm sewer (no. lin. ft.) MI
CCB no.: 01 f. ( Plumb. bus. reg. no: . Water service no. lin. fl. ..-'1 * i
City/metro l Fixture or item:
k. no.:
r_ 111
■ ".,10i." Abso ra valve
Contractoes representative si 4 ature: rtigmhigima
Back flow preventer MI
Print name ''''' ''' •i' 1:. (AH Lt.--ft) a Date: Mall.
• Backwater valve 111111 11111111
:t 04.0
(0\ I \( 1 ' Pr 11 ..so x ' . Basins/lavatory Mill PIM
.‘,.....,,..,..,...: ..,41
,.., '04: •
Name ": ' ' ' Clothes washer Mill
Address . , Dishwasher Ell • : :
11111
'; IMMINIMMI Drinking fountain(s)
• State: ZIP:
Ejectors/sump 111111
1; 1: Phone:' ', ''''"':, Fax E Expansion tank MI
-..,
()I■ .1 It Fixture/sewer cap MI
„.„ . .
None • rint):' • " • ' ' ' Floor drains/floor sinks/hub MI
Garba le dis raosal MI
c Mailing address: • ' •
: :k.'10,..4g • . -,-,,,4/... : , • Hose bibb MI -
CI • , , . , State: ZIP: . Ice maker MI
Phone: ' ' Fax: E-mail: Interceptor/grease trap 111M
Owner installation/residential maintenance only: The actual installation Primer(s) MI
1 7'."4: ' will be made by me or the maintenance and repair made by my regular Roof drain (commercial ME NM
6
,wq+ emplOyeepn the prOperty.1 own as per ORS Chapter 447. Sink(s), basin(s), lays(s) III M
Owner's' st ill
, .....ww. .
rtrivii ! : ture' -, - :AY' ' • Date: Sump 11111 11111,1
IM 1111111111
I • \GIN! 1 It Tubs/shower/shower pan
Namol i Urinal 111.11 111111M
i .. , ,,
• „ .
P 4 , t4Vp , Water closet INN MEI
Address:'' ' — ' '''. - "
, • Water heater 111111
n ty ‘ „,!zo,7:, . ,
State: ZIP ‘ - Other: IIII WM
Phone ” . ' Fax E-mail: ' Total 111111 uta
•
Not an j ctions acct pt credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $
.:46::-.Z` U Visa ,41. 0 MasterCard :
expires if a permit is not obtained Plan review (at %) $
Creditcard number / / within 180 days alter it has been State surcharge (8%) .... $ 7o
4 ': , . Expires
TOTAL $ - 7(7 P
accted
.r - t......,'llis-pr".. . ^, ,-- Name of cardholder as shown On credit card
ep as complete.
• " "^,
$
, IN:;gf.74; Cardholder signature Amount
440-4616 (6/00/COM)
.•,: , ,i'`it, .:.
• T;V:::•'• ' .
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INS CTION DIVISION Business Line: (503) 639 -4171 MST
/� //__ BUP
Received / Date Request S/i `f` PM BUP
Location / 7" 6 U "7(p �� , Suite / (off- G� MEC r �
Contact Person Ph ( SD5) � � T ' 7 �Q " / Cr 3 O O l 7 /
Contractor Ph ( ) SWR
BUILDING Tenant/Owner- —� ELC
Footing � v'� -,`,
Foundation ELC
Ft Access:
9 Drain ; a1c� ;/ ELR
Crawl Drain -
Slab Inspection'N:otes: - SIT
Post & Beam
Shear Anchors /30� v , ' ' J `
Ext Sheath/Shear V C�
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
=RT FAIL ✓�,��'',Y
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Oth-,,
•AS PART FAIL
CHANICAL
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 Please call or reinspect': n RE: Unable to inspect — no access
Fire Supply Line � l
ADA r /
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL