Permit CITY TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES
PERMIT #: PLM2001 -00432
Ili 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 9/10/01
SITE ADDRESS: 14130 SW 105TH AVE 004 PARCEL: 2S110AA 00200
SUBDIVISION: CANTERBERRY TERRACE APTS. ZONING: R -12
BLOCK: LOT: 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: 1 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: Water Heater replacement.
FEES
Owner:
Type By Date Amount Receipt
OHANESIAN, LEE + DONNA PRMT CTR 9/10/01 $72.50 27200100000
c/o SKL PROPERTIES LLC 5PCT CTR 9/10/01 $5.80 27200100000
P O BOX 230703
TIGARD, OR 97281 Total $78.30
Phone 1:
Contractor:
STAN THE HOT WATER MAN
PO BOX 33157
PORTLAND, OR 97292 REQUIRED INSPECTIONS
Phone 1: 503- 760 -2992 Final Inspection
Reg #: LIC 130755
PLM 26 -632PB
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: , Permittee Signature: 4007 - `7 I-''.
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
09/06/2001 15:21 7610159 STAN THE HOTWATER MM PAGE 01
S -83/ Yk
- A Plumbing Permit Application
Date received: 9'/pia / Permit no. ? f/j gp _p/]r//c3/;‘,.
'/ .
City of Tigard (7-/6'
Sewsr permit no.: Building permit no.:
Address: 13125 SW Hall Blvdz Tigard, OR 97223
C+ry ° i n r" Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 — Date issue By:� Receipt no.:
y A)S F'- gait t sr ci Alt., X 39— yi z . .
use approval: Case file no.: Payment type:
I\P1. 01' 1'11011I
0 1 & 2 family dwelling or accessory r' 'mmercial/industrial 0 Multi - family ❑ Tenant improvement
U New construction U Addition/alteration/replacement U Food service 0 Other
.1011%111 I \1ORM HI ,StIII1)111 ( Iur91.'t i. 11 intnrMatiuiiu,L•ciuc,l.li,1)
Job address: V/,3D ' • C.0 /0S '- D uscai Qty. Fee (ea.) Total
Bldg. no Suite no li • New 1 and 2 - lolly : only:
Tax map/tax lot/account no.: ( 101 ft. far each utility connection)
SFR (1) bath
Lot: Block: Subdivision: - . ( PT
Pro'ect name: M - .N fig £ � t A-t' SFIt (3) bath
Ci /coun : ✓6 ZIP: Each additional bath/kitchen V
Deacription and location of work on premises:, VA -f 1�?`€■. Site utilities:
!..- ter4 g R.'t Catch basin/area drain
Est date of completion/inspection: " — / - C) / a we l line/trench drain �—
I' 1 1 .11111 \ (. t l ► l It 1(, ()it Pootin drain (no. lin. ft.)
1 anu actured home utilities
Business name: STAN THE HOTWATER MAN Manholes '"
Address: P.O. Box 33157 Rain drain connector
City; Portland State: Or.J ZIP :9722 am : sewer (no. lin. ft.)
Phone: 7 60 9 2 Fax: 7 61 - 0 1 5 9 E-mail: tore sewer (no. lin. ft.)
CCB no.: 130755 Plumb. bus. reg. no: 26 -632P5 tt atersemee no. in. t.) i
Ci /metro lic. no.: 5670 A Future or kegs:
Contractor's tative Si :41 : , -: �� , Abso . /on valve
��'"'��� Bac ow • venters
Print mute'' GC - e.G. ' Date. i 4, - Backwater valve
t ON I . t 1 P1 ItSO\ Basins/lavatory
Name • ,.uLor vl e,... p • , ~ /xt - Clothes washer
Address: '
y `�� Gs �7 Drinlnn: ountain s)
City: I State: I ZIP: l
Phone: Fax: E -mail: Fit - '
4))% \I ' ture/sewer .
Name •Tint): oor • p floor sinita hub
' ° e disposal
Mailing_address:
Hose ,
Ci . State: ZIP: Ice maker _
Phone: Fax: E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer )
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS t3tapter 447. Sink(s), basin(s), lays(*)
Owneea signature: Date: urn .
I \i•INI I.lt Tubs/shower/shower pan
Name: Urin
Address: ,1 4,�ft>'T'�
Ci . State: ZIP:
Phone: FMNIIIIIII B Total
►+gales r+� can prIsliodoa r« MOM i���' Minimum fee
tiss
$ • J
iV Notice, permit in
L M, a�Caca G /aZ Plan review (at _ %) S
Credit coed .. . 4e - - 40 3 "•'"7/I3 - ,S.{ys/ cap if a permit is not obtained
within 180 da alt it h as been State surcharge (896) .... $
/I .. - r t TOTAL $ -76. 3 a
"' �+, as m0i1 card opted as complete.
J•• ••• { MM.* 440.4616 (Q.OQCO)d)
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested —/ AM PM BLD
Location / L 13 b / £ § t "-J Suite 9 MEC
Contact Person Ph PLM f,3
Contractor Ph SWR
BUILDING Tenant/Owner _ woor� , ELC
Retaining Wall ELR
Footing Access: 2% FPS
Foundation L� 1
Ftg Drain !Y' 7(T e" a (6/ — 1 � r SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear -�
Framing i• f 4 -+l ('S °! S' 4 // 4/ ff
Drywall on O p J D CJ i p p� ? � J � ,
Drywall Nailing / J t � '// w ? v� J�/
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Fin
Final
nal
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk /
Other Date 9 J9 4 / Inspector s / / L - 2 - 6V-e_ • Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
s
BUP - Building Permit ELC - Electrical Permit
-4 Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing
4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing -4 Inspection Description Date Passed By
Suspended ceiling Post/beam mechanical
Engineered soils Gas line
Welding Lab Final Mechanical rough -in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector
Fireproofing Lab Final Mechanical final
Final inspection
PLM - Plumbing Permit
Al
BUP — Fire Protection System Permit Inspection Description Date Passed By
Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab
Sprinkler rough -in Post/beam plumbing
Sprinkler final Plumbing top -out
Fire alarm final RP /backflow preventer
Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
-4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final / 5—o /
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 1 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts\ forms \InspRecordBUP.doc 04 /17/01
CITY TIGARD PLUMBING PERMIT
1 DEVELOPMENT SERVICES PERMIT #: PLM2001 -00432
1 DATE ISSUED: 9/10/01
F 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14130 SW 105TH AVE 004 PARCEL: 2S110AA -00200
SUBDIVISION: CANTERBERRY TERRACE APTS. ZONING: R -12
BLOCK: LOT: 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: 1 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: Water Heater replacement.
FEES
Owner:
Type By Date Amount Receipt
OHANESIAN, LEE + DONNA PRMT CTR 9/10/01 $72.50 27200100000
c/o SKL PROPERTIES LLC 5PCT CTR 9/10/01 $5.80 27200100000
P O BOX 230703
TIGARD, OR 97281 Total $78.30
Phone 1:
Contractor:
STAN THE HOT WATER MAN
PO BOX 33157
PORTLAND, OR 97292 REQUIRED INSPECTIONS
Phone 1: 503 - 760 -2992 Final Inspection
Reg #: LIC 130755
PLM 26 -632PB
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 moit\
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: I. - ` 4 / Permittee Signature: %
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day