Permit r CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2004 -00460
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/1/2004
SITE ADDRESS: 13530 SW 121ST AVE PARCEL: 2S103CD 04400
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:
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: Kitchen remodel, relocating: dishwasher, disposal, ice maker & sink.
FEES
Owner:
Description Date Amount
BROWN, MICHAEL J +
RIES, JUNITA M [PLUMB] Permit Fee 10/1/2004 $72.50
13530 SW 121ST AVE [TAX] 8% State Surcharl 10/1/2004 $5.80
TIGARD, OR 97223 Total $78.30
Phone :
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone : Rough -in Insp
Gas Line
Reg #: Final Inspection
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 -0100. You may obtain copies of these rules or direct questions to OUNC b calling (503)
246 -6699.
Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
<<
RECEIVE!'
Sep 28 04 03:50p William H. Hooper 1 7004 503- 643 -7011 p. I
VIII CI, iuV• AU; LO !M AuO01/O1. SV • 41141 VP 4 I "Ipair •y■VO
1.011rUe t A ARE)
BUILDW ,,, �: . ;,
Plumbing regain Apoltnnion .
City a Tigard Mimi P"'"INNC--t5Y4=q:713;eleit6
13125SW WY awd., Tim, 01t fl!7! i il■6.. or.....d i•►: L - a y y 0 24 Airy_ --li.e ID6PA sore "� [ Swifter/Law For SUMILINII A gili k Omer Maw
Imam yorevoi.sisrlor4o Deem Viss1-24waydwalkiefacliee On R IWO& WWI iasM.lvO
- „*.�- f lt(t)b.i 211
. ed'- IWrbwdUS . ❑ Caanstiolibisolt stt<Rlai. • UM
ICI migmaerbst _ ❑1a1s-_ . stR(3)a.da > As
lsoholilL.sib.IMa.sax 4140
13 Mow Weer Qodor: >rs> ( 2 n - 'Mes
lob dos Mew 43, j►j f -'^° / Clsi.d..raw.w.: ito
CieggiolOMW r7 ”- .9 -P? arm& hub Wm, or oomph &is 1640
SnM1is)4 ms : llyoota� F"'Isa.h. OM c...r sue,, �1
ofwholwd boom viler. IMOD
• tSesasswGosi ajdbiBc bamtmits MO
Ada Elio ....s>re 1440
S airoy moor (iS. Yss 1t:,.._) toga!
Swas.e.er(es.indrd?.,.1 Page
9idtitiwc Mss,: ltirs.s•iecOm ohms 5-�_' I tow 2
_ P i irNi. aboomilo aim IMO
�:JuI
1440
// i .... E_rirtnk ito
aiptsuilaut 7 lu, /2 9 JaaS ISM
s - a— - rum( ) «is .. 16.10 .
. _ � n.iii.� MAO fT Ta�iAre.i�a:�' • • 1 / _1Li —Q J i____ *NOM UMW , . 4 - i.1aMe4e.�.e mw is 0
Gasoea•oe= • fL,z, hee)770 MiicitPs(Wu=2_) Piga2
Addison //, .,p S_6,J. Lu C am-: rri.a. 14.60
LI b. ac, l 7ZZ.� • MO)
Figio (9 l.7/ 0 7 t = (503 A13 ill gip., 16 c►
Stn: trial sad
>,.r.es mow A 7 --x p/cc,0er Af ,csrc. Wo Mier MO
w /.5 3 C) s- ,3 �►tar .e ci °". 1 Soeesirl
Zlr: „9 ei Y' '. 97 0 '__ M4siiia.. yank for. 510)0
��3) &---<7 .5 7s �'. 6.5 78' 3 / woi.rdk.ad...:..>,irsia Ii. :s 41-, _ -
OW 1iie. `y oo
Aick.eisOI T
( Sloe grew= ALPERMI , `.1
J Pao snow 7 7 ,0oi i tkew91' -t 1 ( 7s4 �
>�e�ti.eexpositsp eiti.sstIlsasdleitlrs
/ MI dip shar It Ms bra *espied as emplem.
*Vet rwa+ledelrpt TA-Cooney Bukdinf i.d.ta, Sinks 'bird.
•Ol.sisIg/. Me eiic.l INTO i00•Ma1
T SLES- LS9 -EOS eE0:L0 i+0 82 daS
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested ��c� -3 AM PM BUP
Location /35:0 1 1- -/ Ave. Suite MEC
Contact Person 31 /1 Ph ( ) ' ,-1-4:.¥1.1 425 at) a ¥ -op
Contractor Ph ( ) 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 ll , ` I*, Firewall V W' � V A k 1 4 11
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBIN�
POST & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer 11))12
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
• • =r:
ar
PART FAIL
ANICAL
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 for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
4
Approach/Sidewalk Date 2 - Inspect() at Ext
Other:
Final DO NOT REMOVE this inspection record from th ob site.
PASS PART FAIL