Permit CITY OF TIGARD PLUMBING PERMIT
�'I& DEVELOPMENT SERVICES PERMIT #: PLM2001 - 00236
'� r � J 1 l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/13/01
SITE ADDRESS: 13332 SW 129TH AVE PARCEL: 2S104DA 03000
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 016 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: 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 back flow preventor
FEES
Owner:
Type By Date Amount Receipt
EVERGREEN HOMES, INC. PRMT CTR 6/7/01 $36.25 27200100000
15890 SW BULRUSH LN 5PCT CTR 6/7/01 $2.90 27200100000
TIGARD, OR 97223
Total $39.15
Phone 1: 307 - 7117
Contractor:
DMS PLUMBING INC
12602 NE 28TH STREET
VANCOUVER, WA 98682 REQUIRED INSPECTIONS
Phone 1: 360 - 254 -4539 RP /Backflow Preventer
Reg #: LIC 80744 Final Inspection
PLM 37-271PB
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 -198 .
Issued By: i / Permittee Signature: kle-grali
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next buss ess day
JUN-11-01 MON 08:39 AM DMS PLUMBING INC , ._ 360 254.43,9 _ ...____ _ ,__P_,., 01
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• Jun 10 01 07:56p Chris Lee 503-579-0775 P . 2
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Plumbing Permit Application
City of Tigard
Dutereceived: , Permit iLaj frk 700 / ...a..90,„
A.
. _
1. Sewer pennit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223 --- ----------________
City of riga rd
Phone: (503) 639-4171 Project/appl.nn.: E.xpiredate:
Fax: (503) 598-1960 Dare issued: By: I Receipt nO.;
r _
Case file no.: I Payment type:
Land use approval: ._._
• 1 f I : 1 .
3 1 & 2 family dwelling or accessory U Commercial/industrial 0 Multi-family 0 Tenant improvement.
0 New construction U Addition.falte ration/replacement U Food service 0 Other:
. .. .. ' . .. • Oil S ' T f) ...-- T ' • .:-' '' ... -' f 411 ' ' • I . •'. - ' •
4 . ..11F_ )ly i ...,:flif.P1, ,,....„..,...„.. :. ..,„ .. ,,._,.FF.t. f■ I 11:. _,.1,F... for ntqiikttn okination use c teckhst).
Job address: 13332_ ,5 f t, Description qty. Fee(ea.) Total
New 1- and 2-family dwellings onJy:
Bldg. no.: Suite no,:
- — - - , (includes 100 ft. for each utility connec(ion)
Tax map/tax lot/account no:
- (1) bath
Lot: ib IBlock: - [Subclivision:4 44 ,aj . 2.,,A6 tjesf SFR bath — _ ______
Project name: -§PIT.W155.1------------
_
City/county ` ro -- TZT — R , 4 1 722-3 - — - Eachidclitromilbath7/17R - ciiin - - ------ -----
Description and loca ion of work on premises: Site utilities:
Catch basin/area drain
-. ,...-
-"-'- T5Iywellsileach line/IreneEt:train
Est, date of completion/inspection:
. - • • • • ,, • , ••, -.• • •• • Footing drain (no. lin. ft.) -
. • PLUNIBINC CONTRACTOR • , . .
Manufactured home utilities _.,. .
Business name: S")/vt (. _ Manholes -- ----
--.-
: 12622_ j1/41E...._2c 5f .‘" Rain d connecloi ---
Address ------
---- ________. ______
City: VerAncm ,r4s&r [State; (Alis-T ZIP:i 2.. - - Sanitary sewer (no. lin. ft.) _
..• Phone: 4 -41"351Fax.: i E-mail: -- Stoms sewer (no. he.
_
. • tomb bus reg no 37- ap
,A ,,,,,t v -- 6 - c,,e________;- , • - . • Water service (no. lin. ft.) .........._—..— --
- 'Plaint. or item:
City/metro lic. no.: ,Zd1c5"
- — -- Absorption valve
Contractor's representative signature: ., ,-- —
Back flow preventer --.L—________
Print name: 0. % le. . ,..., . or l Date: 1„, - / .. e l
_
• . ' , CONTACT PERSON .. • . .. ' - flasin's/laliiirory -
— - - • ' - ' - • • ' " _
Name: ChVi Lte, Oodles washer
Dishwasher
Address: t t•- - Drinking fountain(s)
city: 7 ti e ",,s\ State:ciP1 7-TP: 022_2_1
Ejectors/sump _—__._
Phone: 7-7(i1 Fax://13 -077 E Expansion tank _ - ., —
- FTxtuiirse - w - er cap --- _ . - -- - - - - -
Floor drains/floor sinks/hub
Name (prietL_Sike04161 *74f44 141 c., - .—
Garbage - disposal _
Mailing address. ( mi sc r3 t r - __Hose bibb
,N •rate: OR- ZIP: .5 ___ Ice maker ..
_ ----- - -- --.—
Phone: t74)18 t i -7 . I Fax: (-51)pi '-mair: Interceptor/grease trap _._ .._,, _ _ .-.--- -.- • -•• ---
Owner installation/residential maintenance only:the instaia61-M*--mer(s) - -. ---
will be made by me or the maintenance and repair made by my 'regular _ Roof drain (cot;imercia.1) -
employee on the property I own as per ORS Chapter 447. Sink(s), ba la,7s(si _ - -----
Owner's signature: _ Date: Sump ___--- -
ammilliMm pan --- .—
Urinal
Name:
Water closet —
Address: Water healer
City: .. ( State: "ZIP: - -
Other:
Phone: I Fax: TB-mail: Total .
—
------ —
S _ --
No di ionsthctions writ* .twAL .ds. nioase AllIJunsalcdon/O77nOceinfonoa. Notice: This penn it application Minimum foe
0 Men 0 manarCard Plan review (at %) $
1 expires ir permit is not obtained -----
Gdit ..rd numbte
within 180 dap attcr it hos beta State surcharge (8%) .... $
ANTES
TOTAL $
Nulls Or ettallifilard st dine at Redo enT-- accepted as complete. -
s
---- e.....1.04.--..,....0..... Artful! ''. acLai6 AtOJCOAD
_... .........
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested 7- AM PM BLD
Location 1333 Z / Z7 Suite MEC
Contact Person Ph 307-2/1 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall at,. 0,V kr f/ ,i '-' 4 ELR
Footing Access: /
Foundation / Z C FPS
Ftg Drain / SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _
Roof
Misc:
Final
PASS PART - FAIL
(
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer C
Rai rains
SS PART FAIL —�
NICAL
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 Date l
Other ate a / I t
nspeco i �/ o . E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
3`
°. CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested C' Z / AM PM BLD
Location / 3 3 3 —sw � 4`( Suite MEC
Contact Person Ph J ' 2/ / 7 PLM Z - 0° 3
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: v
Foundation / —� O �j L G, FPS
Ftg Drain / SGN
Crawl Drain Inspection Notes:
Slab
Post & Beam SIT
Ext Sheath /Shear Q (4 < I H 11° co _
Int Sheath %Shear
Framing '� /�� R�C62 (,/. ..z 9 i., °r p.� S[� u t) T �Q�i/�
Insulation L
Drywall Nailing 17( OP 10 11 de t'/ '- .
Fire wall T V � --
Fire Sprinkler o � +` /? ►'t �� EA re I-c pr -c R
Fire Alarm
Susp'd Ceiling 0 lot L� C J o f.
Roof
Misc: f �� -e r ,L -0– • /l ice ‘/-Q T-Q�
Final i y
PASS PART FAIL 7 (t 1/4 /d // G? �Z ' s' - E £, +, /�" eJ d ,. �4
UM !� �� � �/UcJ ' /� .�� a
Post & Beam J �,
Under Slab &i /r''''' I 7 " -E
Top Out
Water Service
Sanitary Sewer
Rain Drains
t Fine>
PASS PART FAIL
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
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 6/7/ / � )
Q ! Inspector / / v.e , Ext •
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job. site. .
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 I 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
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils
Mechanical rough in
Welding Lab Final
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector
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
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump / ,fill septic tank
Foundation walls Plumbing final 7- o
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
M f • -
CITY TIGARD PLUMBING PERMIT
� DEVELOPMENT SERVICES PERMIT #: PLM2001 -00236
" A 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/13/01
SITE ADDRESS: 13332 SW 129TH AVE PARCEL: 2S104DA 03000
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 016 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: 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 back flow preventor
Owner: FEES
Type By Date Amount Receipt
EVERGREEN HOMES, INC. PRMT CTR 6/7/01 $36.25 27200100000
15890 SW BULRUSH LN 5PCT CTR 6/7/01 $2.90 27200100000
TIGARD, OR 97223
Total $39.15
Phone 1: 307 -7117
Contractor:
DMS PLUMBING INC
12602 NE 28TH STREET
VANCOUVER, WA 98682 REQUIRED INSPECTIONS
Phone 1: 360- 254 -4539 RP /Backflow Preventer
Reg #: LIC 80744 Final Inspection
PLM 37 -271 PB
ki
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 -198 .
J i
Issued By: � � Permitt Signature: �. `..
loop-
Call (503) 6 9-4175 by 7:00 P.M. for an inspection needed the next buss ess day
Irlib