Permit r kj .. CITY OF TIGARD
PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: P 7/2004 -00203
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/7/2004
SITE ADDRESS: 14202 SW 132ND TERR PARCEL: 2S109AB 09200
SUBDIVISION: RAVEN RIDGE ZONING: R -7
BLOCK: LOT: 021 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: Irrigation backflow device.
FEES
Owner:
Description Date Amount
SIMMONS
14202 SW 132ND [PLUMB] Permit Fee 5/6/2004 $36.25
TIGARD, OR 97224 [TAX] 8% State Surcharp 5/6/2004 $2.90
Total $39.15
Phone : 503 379 - 3137
Contractor:
GROWCO LANDSCAPING
KEITH M SEE
164 HARDING BLVD REQUIRED INSPECTIONS
OREGON CITY, OR 97045
Phone : RP /Backflow Preventer
Final Inspection
Reg #: LIC 6895
PLM ALL PHASES & BA
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 by calling (503)
246 -6699.
Issued By: i i . _ ' / Permittee Signature: ��
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Maj 06 04 02:33p Bud See 503 - 723 -9679 p.3
'0S /0242000 16:25 -FAX 5035981960 CITY OF TIGARD 0003 /003
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Pluuibin P t, atj n o=
Permit N Received � riumb �va
EtteBY: (O /.... �CJA Permit No. Lail
Sewer
City of Tigard N\( b 200 t°'n`a $ • , . t'rtr►wlt No.:
13125 SW Hall Blvd. l I,-' P 1u w Outer
•
•
Tigard, Oregon 97723 GIN O F O • ... : oricr+ Land N
Phone: 503. 639.4171 F �, k�cfgrO tI! u . { 3; 1 • . Dl . iaB : cmc wo.:
Internet www.ei.tigazd.O>` a °11 Contact 1 '4 Sleet Page 2 for 1
24 -hour Inspection Request; 503 - 630 -4)75 "' ' "+ Name/Melba i Supplemental Information. •
J
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l: :g : ; L.. : ! -' X14' :'•'' ,'rlit,P.E:OI:_WOR•1C�: ' •__:: ',.V ',: '`:.:REE *zSC:OR 1 - 7C°(forapccl lym .. i •
.! .
/ 2 New construction - Demolition nmeript[on I QtY• I Fee(e ) I
• '...1... < .,� 'e�' : � c " '1.'1CM %'X4��C•'•i1+ll�ld!�CIZ r• `. •• . •
dition/alteratienh ;:1.; 3 ; " • ' ;04 . 66 ii xor e■"'' s >"!� t=om'. _ 1• �-._;
Ad a laeement • Ocher. 7 ';'�, :. ,nei:+bs: e0 5iik G . i iiiV oa ; xr. , ,.r.•; ?- `.
W Sl:; ;N -'1�' IG�.i:T1EGCi;;'1l:OF_ • 1RUCT Or 4 :'i': o - ti.
��� �- sr•>; (l) bath III 249 "20
`I 1 & 2 Family dwelt • ■ Commercial/Industrial SF1t z bath 350.00
PI Acccss0ry Building ❑ Mu ti -F Family SFR 3 bath 399.00 r •
•
Mater Builder 0 Other: Each additional bath/kitchen 45.00 j
`. OS F.EX`. ORMATIONfiiad :OCA'T1ON;';"V8;i .MA.. Fire sprinkler - s9. ft.: � PeAc l •
lob site address: f ? T... V l :?� ;A=te �'s.:, s . y X
$ JAei. #: Catch baein/areadrain •
Suite #: - Drywell /leach line /trench drain 16.60 -
Pioject Name:: jl 1ry11' )(2,eN `, Footing drain (no linear ft.) _ Page .2 '
Cross street/Directions t0 job site: Manufactured home trtiliti 110-00
Manholes 16.60 •
Attain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2 '
-
Storm sewer (n0. linear ft) Page 2
Subdivision: Y,Ot #:
water service (no. linear fr. P: .c 2 . •
Tax map arch! #: paK ►.uAft: f ,.? , �,`� c�,� .
:•.�,, : ySi'" 4r0io X c111'. a. i......:
,`s.:; ':+• ;: a ;.Y: :IPESG'KunftzoN5OV;WORK ., ..i _ - . :' -''• ,Sbs. ion valve 16.60
_ 13ackflew preventer _ Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60 '
Thinking fountain 16.60
"']l: 0 ' rY`Q. ''ra "'.... sCC'I' RNA2i1v. ''•;i4),:'i':! . pjxtors/sur - 16.60. •
Name: S 1 y 1J v1G -Y\c' Expansion tank 16.60
Address: 14 201- .S'�/V ;'2,'7_� Fixtu eat 16.60 •
• Floor drainmoor sink/hub I6.60
C1 /State/Z12: iV ' 1 = -- (7 1 2 Garbage disposal _ 16.60
Phone: C 1C ? ' Fax: _ !lost bib 16.60 •
Et '• LICA. NT4:'.', 11:` '`tT;;.''•i' ;).•,.1 :NEsicOrr?A 11R ,l�,trO�Ntl'c"Mi "'' Ice maker 16.60
Name: If 0 . i0 /_/ /S �� f /� G _lrltcrtxptor/�roastcrap 16.60
�r Medical gas - value: S Page 2
Address: / /g o , i•K / //. Pei `_ . 16 . 6 0
" I './/,�I]I ii iii ' . j" , Roof drain (commercial) 16.60 •
Phone o . - fi- .41 1 Vui t • ' . ...f 1 / Sitlklbasidtavatory 16.60 '
E-mail rnlN(t) (n Yi.0 /e.7 r Ir + Or) Tub/showcr/shower awn _ 16.60
. •. :,
,_�;.. . ,. - r w;j C
��i.; z '. ar::7: ? ,:_• U tinnl _ aG -GO
Water Closet 16.60
Business Name: enwe 1 .1"1 5 water heater 16.60
Address: • • 1. /, . 4 i : ! other:
I]f L� • 1L 'S ��r Other y,:,.:.1•V
. :', r:.scl �:7,ati bi»,�a� tOt r tt • : 4 -s, 1':
Phone r i rZ F.� e,i - 91P7� Subtotal 5 -- CCB LJC. # t. ! � Plumb. X.ic. #: i / Minimum Permit Fee 57230 $ 2
Authorized S r Residential Backflew Minimum Ent 536.25 -
S
Signature' �� • Dater Plan Review 25% of Permit Fee $ •
4 r
�11fw ..► state Sumner ;e 8 %of Permit pee S ,,an 0
(Pkase print name) TOTAL PERMIT FEE 1 ...f AS
Nod. Thu permit application espirca Ka permit, is nen obtained within Au -cur cemmertial buildings remakes 2 nets of pima with barteorie Or
la0 day, attm 1t has been •ccrptcd If oomDlCte. elate diarnm for plan review.
- •Yee mncthodolop' set by Tri -Count Boadlna Industry Snvsoe 8esed•
ODstsu'c nIsFormssMmPcrv+itAnp.doc 0t/03 • . , .. . •
CITY OF TIGARD 24 - Hour .
'
BUILDING Inspection Line: (503) 639 -4175 .
INSPECTION-DIVISION , , 4,-- ,,,,_, MST
Business Line: (503) 639.4171
V BUP
Received - 5 9 Date Requested 6 _ -, � '�AM . ' PM BUP
Location /e/a0 2_ -13'Z l (l` _ _ Suite MEC _ `
Contact Person a . Ph ( ) A / o5s' �� -JZ) 2. U,5
Contractor Ph ( ) ' • � . SWR
BUILDING Tenant/Owner : , . .. = ELC '
Footing \ 'i I P 1 44. : k
Foundation ELC
Ftg Drain Access: ,r f - w ELR
Crawl Drain 4.) -.
Slab Inspection Notes: , z SIT
Post & Beam i .; , , -
Shear Anchors
Ext Sheath /Shear , 1 „ '`�
Int Sheath/Shear
Framing
r
Insulation ' •
1 Drywall Nailing - f
Firewall s f'=
Fire Sprinkler y
Fire Alarm •
Susp'd Ceiling .
Roof
Other:
Final ` "
PASS PART FAIL
PLUMBING .
Post & Beam
Under Slab
Rough -In •
Water Service • •
•
Sanitary Sewer •
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pa
• per:
C PART FAIL
HANICAL b a
Post.& Beam -.
Rough -In °
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL E
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date .C72 Qrl i - Inspectors i i k Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL