Permit CITY TIGARD PLUMBING PERMIT
A DEVELOPMENT SERVICES PERMIT #: PLM2001 - 00305
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/17/01
PARCEL: 2S103CD -00200
SITE ADDRESS: 13535 SW 115TH AVE
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 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: Installation of residential backflow prevention device.
FEES
Owner:
Type By Date Amount Receipt
WALKER, ROBERT J /KAREN R PRMT CTR 7/17/01 $36.25 27200100000
13535 SW 115TH 5PCT CTR 7/17/01 $2.90 27200100000
TIGARD, OR 97223
Total $39.15
Phone 1:
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED INSPECTIONS
RP /Backflow Preventer
Phone 1: 691 -6166 Final Inspection
Reg #: LIC 87906
PLM 34 -250PB
i X/7 r e �
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 0
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 NO
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility W
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 thri •h OAR 952 - 0001 -0080.
You m- • • ain copies of these rules or direct questions to OUNC by cal • (503) 246-1* ;7 0
Is ued By:: � � %�hli� � � L Permittee Signature: 4 orim
Call (503) 63: -4175 by 7:00 P.M. for an inspection needed the n •T usiness day
BU P - Building Permit ELC - Electrical Permit
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 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 � Inspection Description Date Passed _ By
Post/beam mechanical
Suspended ceiling — Gas line
Engineered soils I
Welding Lab Final Mechanical rough -in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Smoke detector
Structural observation Mechanical final
Fireproofing Lab Final — —
Final inspection
PLM - Plumbing Permit
BUP --Fire Protection System Permit Inspection Description Date Passed By
Plumbing underslab
\I Inspection Description Date Passed By _ Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough in _ Plumbing top -out
Sprinkler final _ _ RP /backflow preventer
Fire alarm final Rain drain
Storm drain EXPIRED
Water service L4 /I t/ 6 5
SIT - Site Permit Sanitary sewer wv
Inspection Description Date Passed By _ Culvert/catch basin A
Footings Pump /fill septic tank gleirr
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils -I 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