Loading...
Permit CITY TIGARD PLUMBING PERMIT Aso' o' I" DEVELOPMENT SERVICES PERMIT #: PLM2002 -00409 !+� At 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/28/02 SITE ADDRESS: 14680 SW 76TH AVE 086 PARCEL: 2S112BD 00100 SUBDIVISION: ZONING: BLOCK: LOT: JURISDICTION: CLASS OF WORK: OTR GARBAGE DISPOSALS: 1 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: 1 RAIN DRAIN: ft Remarks: Replace plumbing fixtures. FEES Owner: Description Date Amount WASHINGTON CO. HOUSING AUTHORITY 111 NE LINCOLN ST [PLUMB] Permit Fee 10/28/02 $99.60 #200 -L, MS63 [PLUMB] Permit Fee 10/28/02 $0.00 HILLSBORO, OR 97124 - 3082 [TAX] 8% State Tax 10/28/02 $7.97 [TAX] 8% State Tax 10/28/02 $0.00 Phone 1: 503- 846 -4794 [PLUMB] Investigation 1 10/28/02 $99.60 Contractor: [PLUMB] Investigation 1 10/28/02 $0.00 ALBERTA PLUMBING Total $207.17 LEWIS TRANER PO BOX 55031 REQUIRED INSPECTIONS PORTLAND, OR 97238 Phone 1: 503 Rough -in Insp Final Inspection Reg #: LIC 96782 PLM 26 -707PB 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 lss -d By: , / . ` A Permittee Signature: Call (503) . • -4175 by 7:00 P.M. for an inspection need the next business day Building Fixtures Tigard Plumbing Permit Application. OFFICE USE ONLY c--Oil I,Ilol l u 1 L) L Date received: /04 el p-- Permit no.: 1-1 t r°= City �� ,` �{ ''J of 'f'i g Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OI1C912232 D 2002 City of Tigard Phone: (503) 639 - 4171 Project/appl. no.: Expire .ate: Fax: (503) 598-1960 �`' � it Ur 11U; Date issued: Receipt no.: Land use approval: '•` • ., Case file no.: Payment type: ' , ` ,. TYPE'. OF PERMIT :- • • F` ' . ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition /alteration/replacement ❑ Food service ❑ Other: ' "' .'' ' `, JOB SITE. INFORMATION „ • ' . - FEE SCHEDULE (for special information use checklist Job address: /q4036 �j(1.) 7 �Q;{, co" Description Qty. Fee(ea.) Total Bldg. no.: I Suite to no.: - '- /_ New 1 -and 2 -family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: (Block: I Subdivision: SFR (2) bath Project name: SFR (3) bath City /county: I ZIP: Each additional bath/kitchen Description and location of work on premises: S ite utilities: Catch basin/area drain Est. date of completion/inspection: Drywells /leach line /trench drain � ;" ", : ." . . PLUMBING CONTRACTOR. ` ,� Footing drain (no. lin. ft.) .. � Manufactured home utilities — Business name: . .4.1 1 k - Manholes — Address: c ' .3 "1 Rain drain connector City: / ` 1 State• ZIP: q723 8 Sanitary sewer (no. lin. ft.) Phone:*g 32( 9 ' ax: S(/ � mail: Storm sewer (no. lin. ft.) CCB no.: ©get 7 z, I Plumb. bus. reg. no:26_7Q 725 - Water service (no. lin. ft.) City/metro lic..no.: Fixture or item: Absorption valve Contractor's representative signature: � � Back flow preventer Print name: _ , , ate: > d L Backwater ve ,"'.: 'CONTACT, PERSON, - Basi at Name: = , , . 0 . ..1 , f S, e� 40444— Clothes washer • ''i • _ Dishwasher Address: Drinking fountain(s) City: I StateQr ZIP: q7-45 Drinking Phone: ' dg if • •. Fax: E -mail: Expansion tank a = OWNEW - - Fixture /sewer cap Name (print): Floor drains /floor sinks/hub Garbage disposal i Mailing address: Hose bibb City: I State: I ZIP: Ice maker Phone: I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular drain (commercial) t employee on the property I own as per ORS Chapter 447. in ), basin(s), lays(s) s signature: Date: P Owner's Tubs /shower /shower pan Urinal Name: Water closet [ Address: Water heater City: I State: ZIP: Other: Phone: I Fax: I E -mail: Total Minimum fee $ C- 1 Not all jurisdictions accept credit cards, please call jurisdiction for more information Notice: This permit application o $ O Visa 0 MasterCard Plan review (at _ /o) / expires if a permit is not obtained • o Credit card number: within 180 days after it has been State surcharge (8%) $ Expires TOTAL $ /0 , 5' Name of cardholder as shown on credit card accepted as complete. f vr I� 44, 4' be; Cardholder signature Amount r VTY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST (L3 BUP Received / Date Requested ii AM PM BUP Location l 1 1 ? 7 Ca - Suite q / MEC Contact Person Ph ( ) 7 4 ! f - Z PLM — DO Yv Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: L,1861 / K , /s 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 /PA� / //_ Susp'd Ceiling Roof Other: Final - PASS PART FAIL x/1 `/� aL ` r Aef PLUMBING �'� �� L // Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Ot y -r ea#6. irk.,' AS 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 El Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA /// Approach /Sidewalk Date jfrY Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL