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Permit C ITY OF TIGARD PLUMBING PERMIT 1 DEVELOPMENT SERVICES PERMIT #: PLM2004 -00036 " �" 13125.SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/28/04 SITE ADDRESS: 14264 SW 132ND PL PARCEL: 2S109AB 09600 SUBDIVISION: RAVEN RIDGE ZONING: R -7 BLOCK: LOT: 025 JURISDICTION: TIG CLASS OF WORK: ADD 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: 1 TUB /SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: 100 sewer line repair and backwater valve. FEES Owner: Description Date Amount CHONG, ANGELINE 14264 SW 132ND PLACE [PLUMB] Permit Fee 1/28/04 $69.00 [TAX] 8% State 1/28/04 $5.52 [PLUMB] Misc Fee 1/28/04 $35.00 Phone : 503- 709 -2576 Total $109.52 Contractor: DECAL CONSTRUCTION 440 COLUMBIA BLVD. ST. HELENS, OR 97061 REQUIRED INSPECTIONS Phone : 503-366-0797 Sewer Inspection Final Inspection Reg #: 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:.' g , / / Permittee Signature: C d -c Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next bu day 01/23/2004 12:18 FAX 5035981960 CITY OF TIGARD 21002 Building Fixtures CHVED • ..- . FOR • nFFIC:E USE ONLY of Tigard P ermit App x N t><o 200k �Ce`VGd - a/ : JAN Reci. / --',3.--1.2 f ' Pe rmitNo,; p e . 13125 SW Hall Blvd., Ti OR 97Z23 Plan Review Other Permit No.: dtin Phone: 503.639.4171 Fax: 503,598. -h" TIGARD l . ,u api'k f fli Date/By: • 1 rl, itil Sac Page 2 for "� � pate Reedy /By Int r net: w6 w.c ian Line: 503 63 ,4 / N�'iNEE -, z- /Supplemental information Internet: w ww.ci,tigard.or.us 11 ai � i' :I:q0' •' .' {. -1I 1 R 1a f. a . ,r. . rr'i ":. iil' . vli U l ;'..i'i • ;'j'j!li r l e •.'ii L 1 I h al 'ill I• I I Vi SC DtTh u f , , , : i. II 1 rl i 1 .1• : - .4 1• r � . `tt'i1 ;0 vi,.i���lll,:'s� i l' '1'NLbr; a�"'� ar:!I' •..�� 1, l! , I fi. I'::,I,,,.:,::••.. For specia l in ormation use checklist. ❑ New construction ❑ Demolition Dcscri.tion 0 Ea Total [] Addition/ alteration /replacement ❑ Other: New t- 2 - family dwellings (includes 100. for each utility connection)" . 249,20 °+ :� ��im : p.rr I :,I'1,'!It I r.i 'I':I ic bath Jp 1 1 :N' ; i,, .jl ;4 .,'.(" SFR (1) ba s : ,i, : I. 'n .• �.? i... ..15...)W.1, : Q WI ' „.. ":!'.:. � .1 yy / 1 i - '' ��` .�, ,:: I' r:: 1'% 350.00 ��yy �;�(���ZI�W� FI 1191 /1G;il n ,Li... �'�•'�i�,'�Il'�Jil' � .'�.��.,�. 1 � � - SFR I'2) bath ❑ 1- and 2- family dwelling ❑ C SFR (3) bath 350.00 O Accessory building ❑ Multi- family Each additional bath/kitchen 45.00 ❑ Master builder ❑Other: ft.) Page 2 '• Fire sprinkler (-_ sq. ) • i, -.for r -N. 4�c '.' d, . ll :.,r, ti ,. .,.,; � : I ': ' " i Site utilities '�.,. Ir1 1 'l. - { . J �1 �-,.. N, a c basin r area drain i y�1r 1 Illi 16.60 Job site address: SGti) i Dt'ywell, leach lint, or trench drain 16.60 City /StatdZlP: �n - Footing drain (no- linear ft.: ) Page 2 Suite/bldg. /apt" no.: ' Project name: _ Manufactured home utilities 110.00 Manholes 1 G.60 Cross street/directions to job site: - - - - _ Rain drain connector 16.60 .- Sanitary sewer (no. linear ft.: /DO) Page 2 $55104) ii Storm sewer (no. linear ft.: ) Page 2 - Water service (no, linear ft.: Page 2 Subdivision: Lot no.: - - Fixture er item Tax map /parcel no .. Absorption valve 16.60 :�irr'. : a ,.. , cl{ a i .a,., r "Ii ,. � ,.. IrvYt ".I i'�jl;li;i 'i'l IC'i ti ?I:,Gijri r,'r ;i !' i l ia' Page 2 41" ---- 0 1: " . I"7••e inNIF ' 7' -J„ h. 'r.'! 1•. :. J I tft 1a .66 i i i ; lq Pi?:!. : i : II kf10W rCVCnter 1 :;,l, .i.,:.a /il'iiT i i't i��'1iF'�>i r iiiai r I�:.r Y11, � . ©!1 1i-,r :1iIji' ?.`.,:. :.I.,: - i1 :44 ;i! ...!. 1.� BaC p �t, 1' C: 9a• L,. �, �.:' �Ii!.,. uI .LGi ........:... ..)i�t•It.u:, O. >J.' " � e _ .21 B kwater vale / �B G Clothes washer 16.60 - Dishwasher 16.60 Drinking fountain 16.60 n; :,�s v1, �i ! •.a '•0•� m ! , I!; iii, }. ij11.1 t � l �liti' •.' "I�:..I al i .:Ii''t` 4,0. 1�I1 .J ' lli.ii; la 1, :', i.l' t �jld,�v,,i�l •�'I����A . ,.9i:..; ����T•,tl,;1::1 r.IUG',t, ,., .... . .. ... E j 16.60 :.•,. 16,60 Name: 1 /, ' 1 (/ k Expansion tank Fixture/sewer cap 16.60 CP • Address: / 7 5 / . 16.60 - Fioor drain /floor sink/hu City/State/ZIP: �/ d 1 ( �v ((17(.... ((17(.... Pax ( ) Garbage disposal 16.60 Phone: C ) 7d 1 '„' ^� Hose bib • .. 16.60 I 1 r r ; :L�i , . �I;It I " P''' 1 C i!,-{ FT ri . 16.60 �,�� + It�tll�; 1 � 1 ,J1 k�� , �i1� C�; �i;' � �r: als..• �" 1re��lia�'.c'� , tpl5�: d ., �� ��r��,wr,:;; Iccmaker • Busine name: Interceptor /grease trap 16,60 Medical gas (value: $ .-_) Page 2 Contact name: ~ Address: Primer 16.60 Roof drain {commercial} 1 G.6D • City/State/ZIP: Pp �v 3 �/s - Ya 5 Sink/basin/lavatory _ 16.60 , • Phone: ( per ) ' : ( = ) Tub /shower /shower pan 16.60 • P.-mail: Subtotal s d Urinal 16,60 ,. r , ; , i2 , ,, { : T I , 4 . t ? ;� :u� n:::�;a;�nc'':1'�':II ?,il`I ; I , �''r,�.[ ' I''r''�'449( °i'i:i1 1 i!t "'; ?Ji:�;:,ll ^ : TJ'iFil� .'Igr!' 16.60 1 'ri'" J '9�II '. 1 ''', 'n li.., y!n jri ,`g. :,h l tL.,;11E .` Water closet . tr: � 'i'�, t'. :i ,: r i ,�,Id�y ;:, }��: ?!: ,.,. if;(t,:: ,.. �:�si'i�• _I��'; LI;,!,....IIC�I;:�ra�' ,., ! hg� .�'�I';i N']1ra:°� :,.i.�ai „I,h?,�.nv n '�.�•!112. .:,;:', :i 1; }(,.60 -i / • t L _ ei , d C d 71 Water heater - � o r3 • Business namt B C�Q u�Other; Address: „.7„7,:„.„-0 C /J d , �f.� / i • • Tqj� .* City /State/ZIP: S % - / 0 4 Q - 7a 19/ Minimum permit fee: $72.50 .6'3 - '366 - 0 "7 9 7 _ Residential minimum permit fee: $36.25 Phone "�� �y C� 6114.01,- in)9 ��rroG CCB Lie.: / S 3 3 /S (:9! I Plumbing Lis. no._ _ ___ State surcharge ( Se/ of permit fee) - /� ^ `TOTAL PERMIT FEE 8 & f� Authorized s_ r::, . °I ,, 4,�. F �' _ permit Is rat obtained chi r j 4 Date: i 3J() f'/ 1 Th p ermit sppltcatian expires If a p I Q Print name ^ -� 180 days after it has been accepted as complete• *Fee methodology set by Tri- County Building Industry Service Board. doe 12/93 4.10 -d 616*(10102ICOMTWEB) � . p,.f " 1 YandtADD- �ll�),.'�1' CITY OF TIGARD r 24 -Hour BUILDING Inspection Lin (503) 63 5 INSPECTION DIVISION Business Line: (503) 6 - 1 MST BUP Received Date Requested ?/ di AM PM BUP I 3 AJ Location 7-4 �. Suite MEC Contact Person Ph ( ) � — a ®o 36 Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PP �S RT FAIL MBIN Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final • PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final i l 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 ADA Supply Line D ? / 3 ` 6 ,__Ext Approach /Sidewalk Inspector Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL