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Permit
o CITY TIGARD PLUMBING PERMIT A DEVELOPMENT SERVICES PERMIT #: PLM2001 -00129 .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/02/2001 SITE ADDRESS: 14455 SW 128TH PL PARCEL: 2S109AA 04000 SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7 BLOCK: LOT: 006 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 backflow device. FEES Owner: Type By Date Amount Receipt O'BRIEN HOMES 5PCT CTR 04/02/2001 $2.90 27200100000 34444 SW LADD HILL RD. PRMT CTR 04/02/2001 $36.25 27200100000 WILSONVILLE, OR 97070 Total $39.15 Phone 1: 503 - 789 -8359 Contractor: HIGHRIDGE CORPORATION, THE 21400 NW CHERRY LANE HILLSBORO, OR 97124 REQUIRED INSPECTIONS Phone 1: 503-629-0193 RP /Backflow Preventer Reg #: LIC 00006221 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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: ` ' r i i , e ,i °- r ,- ` Permittee Signature:O/) A'PP.J /1 - VD)1) � Y A ItIL., Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day . -,, , Plumbing Permit Application Date rec sived:3 —,9 Permit no.: 20 or rpp / 2q �° ",'o7 ',` City S of Tigard - • Address: 13125 SW Hall Blvd, Tigard, OR 97223 Sewer p :rmit no.: Building permit no.: City of Tigard Phone: (503) 639 - 4171 j� Projecti, ippl. no.: Expire date: MAR 2 n 2Qp-Fax: (503) 598 - 1960 1 Lb Date issi By: Receiptno.: Land use approval: Case file no.: Payment type: COMM I i I v_ 1• a 'T 11' 1'1? OF PEANUT 0 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi- family Cl Tenant improvement 0 New construction 0 Addition/alteration/replacement 0 Food service , Other: }i a.c.V.A- 1.o..1bev 1 Le— .1011 SI I F 1NFOR %l:ATION IT!' SC I Mt III (tor special information use cbc•kli,11 Job address: / y y 5 S. S. w . I f _P1 ac e Description Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1- and 2- family dwellings only: Bld no.: map/tax lot/account no.: (includes 101 F ft. for each utility connection) Tax SFR. (1) bath _ Lot: !Block: I Subdivision: SFR (2) bat h Project name: SFR (3) bat h City /county: l ►C \ar - 0 2 I ZIP: 9 "> .. 13 Each additi onal bath/kitchen Description and tobation of work on premises:a.ea,r.g. \r...) )evi '-a Sitentill8es: ( oNr`me.t o c c1■c. - )e..,..icc., '', St . Catch basir /area drain Est. date of completion/inspection: Drywellsllt ach line/trench drain l'1.[ IVIBING CO s I It (1'OR Footing drain (no. lin. ft.) Manufactui ed home utilities Business name: 11 NA *�\..,Y.... a cle C c r P Manholes Address: Q1' Oh 10,W C- he.rrv L.• Rain drain =nectar City: W, \\ ,boro 1 State: OR_ 'ZIP: '7/02 Y Sanitary se Phone: -p _ X ..o - Fax: 3 . E- mail: Storm sews r (no. lin. ft.) CCB no.: , P. - Plumb. bus. reg. no: Water sere: ce (no. lin. ft.} City /metro lic. no.: 0080 ,. ' 411.7 Fixture or item: Contractor's representative signature: /MEW 41 - •sorption valve Back flow ,reventer j 3k1.2.5 Print name: 5C'■ L. t>. a Zo uxt n C } Date: - a 8 - 0 Backwater valve (ON 1A(T PERSON Basins/lavatory Name: Clothes washer ' Address: Dishwashe Drinking ft tuntain(s) City: 1 State: I ZIP: Ejectors/sump Phone: Fax: E -mail: E Mansion tank OWN lit Fixtu sev'ercap Name (print): Y i r ' : J u S Floor drains/floor sinks/hub Mailing address:31+ ijl' j i{ .5, tA) • 1 i A\ s ' , Hose b a b sposal Hose ibb City: \t■l i \ 50 N V i \\ c Fax: State:0 (Z I ZIP: ' 0 0 Ice maker Phone:5 589 -835 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 Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), ba ;in(s), lays(s) Owner's signature: Date: Su , , ', (' lb: Tubs/show 3r /shower pan N ` Urinal Name: ' Water clos Jt Address: Water heat er City: I State: I ZIP: Other: Phone: I Fax: 1E-mail: Total C - Not all juriedctions ac ceps credit cards, please call jurisdiction for more infoanation� Notice: This permit application Minimum fec ................ $ 3/... vZ t7 2. 9 0 D Visa is MasterCard Plan review (at %) $ expires if a permit is not obtained Cr t card number: / / within 180 days after it] tas been State surcharge (8%) .... $ Expires TOTAL $ s3 7. /5 Name of cardholder as shown on credit card accepted as complete. $ Cardholder aigneture Amount 440 -461& (6t00/COM) £OOM tDJVII.L 1O A,LI0 096T 969 £05 KVd OZ:5T 3fLL TO /LZ /£0 CITY OF TIG44RD BUILDING INSPECTION DIVISION f -- � ' 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 `� . BUP Date Requested 76 AM PM BLD � ,/ Location pi ASS (,t) /Z-8'1A �-Q. Suite AIEi; Contact Person Ph L • c t — O° t 2-1 Contraacc+t (6j Ph 1c1 J x3511 _/) ,- Old / � Ui 1LDf 1 Tenant/Owner ELC `nek Retaining Wall ELR g O/ ©d C %0 Footing Access: Foundation FPS Ftg Drain 0 Drain Inspection Notes: AN L. SGN Slab i SIT Post & Beam CO a Ext Sheath /Shear Ina Sheath /Shear 07,-(Z2,00 Framing ' 0 - cto /; l (1. y-{ ` v + 6 _ 6 ("z }� C.) Insulation Drywall Nailing v i ■-■ "" r ∎ ∎ ∎ _ . Fire wall � � S liS Z�� ? 2 Fire Sprinkler Fire Alarm go n Susp'd Ceiling S I goy ? U�^ ��-c �✓�( -�C Mi c: S y._ _ 2 YVX--fi 40_0/ 21 -__ / 9&.S� O : ‹ fir S PART AIL cg framiuNt a1-/ Post & Beam itiederefeb/ Top Out �,/,, 0 Water Servic= f 84/> Sanitary Sewe 04. Rairl..Rrains in ASS PART FAIL EiAtilc Post & Beam Rough In Gas Line Smoke Dampers Ina AS PART FAIL CTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm 044i Final PASS PART FAIL SI ck T Baifill /Grading Sanitary Sewer Storm Drain N [ ] 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 ohil A. • oach /Sidewalk Cl *the �/lS l� Date /gyp /0 Inspector Ex t Fin- - ASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested AM PM BLD Location S1.J / sx-1 Suite MEC Contact Person Ph PLM 1 60aq Contractor Ph - 7e— SWR ' [ BUILDING Tenant/Owner ELC � Retaining Wall ELR Footing Access: �� Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT AiO Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final P • - FAIL PL• 'r= Post & Bea ` _ _ 7 Under SI _ • ', 1 eu Top Out � r Water Service 14 4i Li / 0 l' 0 Sanitary Sewer i Rain rains , yL 1 S °"p » Uz I � Ina ASS R FAIL G MECHANICAL 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 BackfilUGrading 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 / r O r Date 7 % �/ Inspector / i� �� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 0 .04/05/2001 14:11 5036290415 HI GHP I DGE CORP PAGE 04 ■ APR 1 :i 1 :- 200 , , NORTHWEST BACKFLOW INSPECTION & TESTING SERVICES P.O Box 1536 002608 Hiitsoom, OR 07123-1536 I NVOICE CCB 134260 _ - :. 7 E - ) T C . - . ) , S H P T Cy if s 4 ' 4 • ._<,,_... _Cer 5 e tdi;&' ) re ./ - - --- . , ADDRE 2 CT 5 y_ :1 7 - 1.(F .cily 57"LCIE. Z;t at a ." I z# cus T a pARAIR pER,:. i,, z 3 .....ii.O' I rr. -,. . 'L • :.; ;:,, ' . •,:', ,.',1_ 4 " ,...•:; ; , ,: ' - it: '' '" ',';',.. ' : .. "t. VP' A,..X:: I: j , . . ,', -.' ::' ,:.: '-', '‘'..::,::' • :- !---....; . "' ' . :' 7 ' ' ., oro y , - - ' ERED ,-- -::' , Skfc'PEDr.14; '-,i'e,-: : .-. ' , • . 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L . 1 , ,.....1 4ii11.L...Ca..b.0abi...........1...../' \ 1 ' DC,5840 APPROVED V CONSTRUC ION ,-- --, i/ o - .,/ 0 ,,, BUP - Building Permit ELC - Electrical Permit -V 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 Al Inspection Description Date Passed By Suspended ceiling Post/beam mechanical Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final _Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection ��jj�� PLM PY umbin g Permit 7 nspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbin: to -out Sprinkler final RP/backflow . reventer JL(d , ✓'74 Fire alarm fmal Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer -4 Inspection Description Date Passed By Culvert/catch basin / Footings Pums /fill se tic tank Foundation walls Plumbing final • , D / • Sprinkler supply lines AK— _ Sprinkler underfloor /slab Catch basin/Manhole SW R - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS C ITY OF TIGARD PLUMBING PERMIT 'a�.l;� DEVELOPMENT SERVICES PERMIT #: PLM2001 -00129 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/02/2001 PARCEL: 2S109AA-04000 SITE ADDRESS: 14455 SW 128TH PL SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R -7 BLOCK: LOT: 006 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 backflow device. FEES Owner: Type By Date Amount Receipt O'BRIEN HOMES 5PCT CTR 04/02/2001 $2.90 27200100000 34444 SW LADD HILL RD. PRMT CTR 04/02/2001 $36.25 27200100000 WILSONVILLE, OR 97070 Total $39.15 Phone 1: 503 - 789 -8359 Contractor: HIGHRIDGE CORPORATION, THE 21400 NW CHERRY LANE HILLSBORO, OR 97124 REQUIRED INSPECTIONS RPow Preventer Phone 1: 503 - 629 -0193 Final al Inspection Reg #: LIC 00006221 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. S 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 IP Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080. m ow You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: ��y /� �/ Permittee Signature:V/VI ' 17 1I) - Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day