Permit CITY TIGARD PLUMBING PERMIT
I DEVELOPMENT SERVICES PERMIT #: PLM2004 -00392
- -- -�� 13125 SW H all Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/27/2004
SITE ADDRESS: 13280 SW ASH DR PARCEL: 2S102CA -00242
SUBDIVISION: VIEWCREST TERRACE ZONING: R -4.5
BLOCK: 02 LOT: 003 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: 1 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: Repair of floor drain & laundry tray.
FEES
Owner:
Description Date Amount
WATANABE, JANET
13280 SW ASH DR [PLUMB] Permit Fee 8/27/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchan 8/27/2004 $5.80
Total $78.30
Phone : 503 - 598 - 3902
Contractor:
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDALE #8
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Phone : 239 - 8801 Top -out Insp
Final Inspection
Reg #: MET 00003082
LIC 49418
PLM 26 -533PB
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.- Permittee Signature: �i� y
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busi day
FROM APOLLO DRAIN 503 - 669 - 9568 (THU)AUG 26 2004 12:44/ST.12:43/No.6812889410 P 1
I•
1 \W 1'
Plumbing Pe ' I • cation
Datereceived:1P _ Gy Permit no.i?(...\\. j tz
City of Tigard
•11'_ Sewer permit no.: A. Building permit no.:
Address: 13125 SW Hall Blvd Rapq, OR21/0 z3
City of Tigard Phone: (503) 639 - 4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 CITY OF TIGARD Date issued: By: Receipt
Land use approval: BUILDING DIVISION Case tile no.: r)G- Payment type:
1 Pi: 01. 1'I :1t11 I I
141 & 2 family dwelling or accessory U Commereialfindustrial Cl Multi - family Cl Tenant improvement
❑ New construction Addition/alteration/replacement 0 Food service 0 Other.
JOB `l 1 l' 1 \1 1l IT S( III In II (forsperial intorwatinn nwt'lwtklk )
lob addres (3 - 94 Dr . Description Qty. Fee(ea.) _ Toad
Bldg. no.: Suite no.: New 1. and 2-fitmlly dwellings only:
Tax map/tax lot/ (Includes 100fi.foreaditallitycometdor)
SFR (1) bath
Lot: 1Block: J Subdivision: SFR (2) bath
Project name: ,�Q SFR (3) bath
fl Val., 1ti
City/county: ' A.511 I ZIP: C f 2,23 Each additional bath/kitchen
Description and location of work on premises: Slteutll ties:
Diu vYl k iY1A IT.pGl i'r Catch basin/area drain
Eat. date of completian/inspection ry wells/leach 'n re nch drain
Fooling drain (no. fin. ft.)
Manufactured home utilities
Business name: 0 i10 'D r a _ tyl 4.. P L u.YVL IO fL ei Manholes
Address: 22O IN $ I r (- Q%JL G R Rain drain connector .
City: (z' et,ylr1 I State: all ZIP: X70 3Q Sanitary sewer (no. lin. ft.)
Phone: a3 -- gaol 1 Fax: cl .9514 E-mail: Storm sewer (no. lin. ft.)
CCB no.: da 4-1$ Plumb. bus. reg. no: zlo - - 33 p e, J Water service (no. iin. ft.)
City/metro lic. no.: 3 O `s 1� °i Item
Contractor's representative signaxwe: C 441.j['JYVI Absorption valve
Back flow preventer
Print name: 71 { Date: g- to - Backwater valve '
Basins/lavatory
Name: Clothes washer
Address: Dishwasher
Drinking fountain(s)
City: _ ( State: I ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
Fixture/sewer cap
Floor drains /floor sinks/hub _ I Ito le
Name (print): l\ ,...--ru\ l ,3 ti \ Garbage disposal
Mailing address: Hose bibb
City: w 7 — State: ZIP: Ice maker
Phone: T? 39 a.., Fax: E-mail: Interceptor /grease trap --
Owner installation/residential maintenance only: The actual installation Primers)
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), basin(s), lays(s)
Owner's si Date: Sum .
Tubs/shower/shower pan
Name: Urinal -
Water closet
Address: Water heater
City: IState: 1ZIP: Other. 1 (LU,ritt- fta -4YeU.A 1 Ito In(J
Phone: — 1 Fax: I E-mail: Total
'rat a odiektio- --st , pka9e cell iudrdigiaa fa mare inf er Minimum fee $ 77-- Sin This permit application
ekVis' Ca Meate/Cam ` - 1 expires if a permit is not obtained Plan review (at , %) $
( < ord amber: 4 n - 5 � � 1C/t6 - oq9 a"l9 JO 5 within 180 days after it has been State surcharge (8 %) .... $
5 mme m L a+edim card 6xm accepted as complete. TOTAL $ • 3 n
e_.ar $`"I g .30
Cwdbdaer ei5ODUme Amount 440 -4616 (MflCOM)
CITY OF TIGARD 24 -Hour
BUILDING _ Inspectio -Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested g ' 3 AM PM BUP
3
Location /3 gD - o� t � Suite MEC
Contact Person / 2A Oita / Ph ( ) Z � I 38' 0 1 PLM ,; 8 C)
Contractor v e. 11 Ph ( ) (7 I tog 2 73 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
PASS PART FAIL
PLUMBING
§ ab
ugh -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date ?'./ 3 1 0 LI Inspector 1^3 W-A—) ' 1 1 ""'—• Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL