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Permit
' r; CITY OF TIGARD � ' PLUMBING PERMIT , I DEVELOPMENT SERVICES PERMIT #: PLM2004 -00487 II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/27/2004 SITE ADDRESS: 12765 SW BULL MOUNTAIN RD PARCEL: 2S109AD -01000 SUBDIVISION: ZONING: R -7 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: OTR 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: 2 OTHER FIXTURES: TUB /SHOWERS: 2 SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Bathroom remodel. FEES Owner: Description Date Amount SCHAER, JOHN ARLEN + CHRISTI A 12765 SW BULL MTN RD [PLUMB] Permit Fee 10/27/2004 $83.00 TIGARD, OR 97224 [TAX] 8% State Surchari 10/27/2004 $6.64 Total $89.64 Phone : 503 684 - 6532 Contractor: MP (MILWAUKIE) PLUMBING CO P.O. BOX 393 CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Phone : 503 Rough -in Insp Final Inspection Reg #: LIC 5002 PLM 3 -17PB 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: ..ma _ Permittee Signature: �Qe Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next businass day pi OCT -26 -04 14:33 FROM -MP Plu 5036551726 T -545 P.002/002 F -111 Building katures PXum,bin Permit .A licati �°► ;� FOR OFFICE USE ONLY { .E'v Dair i"cd �j7 q � • •Permit No -: 0, y ( .re City of Tigard C Received . / o ff- 1 �/ 13125 SW Hail Blvd -, Tigiardt OR. 97223 Plan Review Ot P ermit No.: 503.598 -1960 OCT. 2 r t,. ,yR',jl; Dat • Phone: r Inspection 71 Fax: '��i' Date Rea B 1�� El See Page z far 24- Hour Inspection Linc: 503.639.4175 d ..a y y4 S uppkineatal Iraformatian _ •rlotinedWe ., ion ti onus Y OF i ': ..i 4"5-5 -. i q.Krr•. Internet: wWW.Cl � . . � , a �, .�, .a , .- -o:: �� .r, r .� r, r _• r , :.yin �.�t�'� �, rypFj4�: �. f � �F „ '� N v r -, -, - ai1vY ;^" -,, . r � f .? r , + ! a f ` } ��{ tg�hy,�ai�{ ,. ,ic a �i:: j�` ., . f a g:1 • ,. ! • J . 0 t u -, • 1 "nr'� � Wli r � •.1 .. 2 J U �,? � � ��ti�l �Y i`I@�141�i . �i - .7 ' � ?;L: - it • err . :U - 3 .'+'+ �t t1a 03,, ,,,a .•-, i ,, 1:ArSU a' '•^� a, s_ �';`.." 7�iuly� .••�" } *;�'�.F~�Ca'il�,_��t ° � �., r x + � - '_r -t � .,.�;rr�'• ,=� •, For special information use checklist_ i 0 New construction Demolition .. -- Desch oion MI Ea. Total IIII Addition/alteration/replacement ❑ Outer: - • llew.1 7 family dwellings (includes 100 ft: for. each utility connection) I :,•: . �a, �;��y< +w^ " SFR (1) bath - 249,20 "i� r'��' r '1� s , ,aEr':,�. .«,'F- �?,�r .r�� ._t`.� ..^ .yt, • _. 11111 350.00 1 vb „jrtk r&' ''* - -. ^.z. :i;_ ,n...:. S�I2 (2) bath In 399.00 1 and 2-family dwelling SFR (3) Bath • • • 0 Accessory building ❑ Multi- Family .. a5 -00 Each sddi5onalbath/kitchen • 0 Master builder . . • ❑ Other Fire .perkier ( " • sq- ft.) Page 2 1 :30-rir. .tis - � :Wr a�sesi i?l,;xe et .3N a 4:`•0 ' A' Iit'es ;:r r + '•'W ,,: LYA , n.., ...... - ,7 1:^.711 - :, : t '• " • .41,_5 ., � Sete fill �, �a,;. °: T 1' t l'^' 3 :, _T,._.� * ,,,r! ss._ ,.,� r.�,,._ 16.60 • �- Catch or arca_drain lob site address: \� ; _ 1 _ 1 Wm._ Rh .. r � � ! 6.60 Drywcll, leach line, or trench drain City/State/ZIP: `�� / d �(� ^�'� Footing drain (no. linear ft-: ) OM - Suite/bldg.lapt no_; - " Project fie: ..,..e- h � Manufactured home utilities ' 110.00 Cross scree /dfrxnons to•job • site: Manholes 16.60 . Rain drain connector 16.60 S anitary sewer (no. linear ft: - Page 2 Storm sewer (no. linear ft.: ) Page 2 _ Water service (no. linear ft.: ______) Page 2 Subdivision' Lot n Fixture or Item • p bsotption valve 16.60 Tax map/parcel no.: t � ;7 � #,` Yi r , i b r_t;� h ' � � r y •� -,?�,3; -1;s �•. .,��-; '�[ = 'W= t.�,:>f ,o+'r�,�,` Baekflow prevcnter `,�'� ,..- c_ ^ • lZ: : alt , i s r a _v uz".,. . n z....-r.:m 8.,E 5 ''�. ;::a;i.Yd- � j:c�.. 16.60 :� gachwatcr v�lvc • �•►�aft�'�s� I ����` Clothes washer. 16.60 . Dishwasher . 16.60 Drinlon fountain 16.60 4r:� :7 -.wr, r}SMti r i' ti a r,;;':' g • 16 -60 > ?:! n ; �:Y: •y Y.. == ..w:.:, a: •_T.c: •1{:i`' :Kt, tfcJt�� 1�J6 y �. r �h... ,, ... �, r e ...tv4 & r �a`� ' w +.a •.• .:�. ' .;r ir e1 k• &G1=Z-1u. _ Ei„tols/ � ra 1 � ( rag ,sr'v. ^F �' �..e',.:?' 115.. s'•- .�::.'a � ..,.�..::.r..�. 16.60 • Name: ..� - a - , - J. Expansion tank • • • Fixture/sewer cap 16.60 Address: - $lone •drain/floor sink/hub • Ell 16.60 City/Smie/ZIP: : © 1 'n- Pho Garbage disposal 16.60 • Phonic: (• ) ) .•, ( _. « . , � .,..,: � �, �. Y;, 16.60 • _ � ,`: �;,,•� ��•� K Bose bib i :;mac a r:.�,. ,,�• Wgi "�: r . 3 191 .. s:! : i1 16.60 .��,...� ;� '�" ,� \�' y�L.1r'✓1r •`��.. �� ?;•tt.�t' ' t�� 31 �4' �`�•,= �t'ti3u�. - '0 '- ' L t: 1:it v i i ?.: _�'i ti• . 4 : 3. � `, V � c � fi r 4" y� ,..± 11 = •`. _ rat.? .. ems Ice maker Business Hama: 1■■■ - _ - • Interceptor /grease trap 16.60 Contact name. .... Medical gas (value: 5 ) 11111 = �����. E. ? • .,. � , Primer 16.60 Address: �} ?pc-a, Primer drain (commercial) 16.60 City/State/ZIP: ` �� • "� � V r � Sink/basin/lavatory 16.60 Fax ; �3) �S Tub /shown /show�.p�+ 16.60 • Phone: (Sa3) Ca `7 l Le) 16.60 r , �..;r -v° Y e„ ' i • Urinal INN 16.60 ' k . r � 1 : r'ST "735 S ::•^�' Y .C: `o - .!' �.';:lia'rd: it garb i ,'. $ - -water Closet •;' ° � `t3{":` :°' � �:ti � .'S" a :Lr�ex:. c 16.60 A Water heater _ Business name: \ _ .�� In ',A . �� Q V Oeizr:- - -..._- - 7ldtix !-- i �,� iii:... � ~ Subtotal City/StatdZIP: Mini mum p�"t fee 572.50 Fax: ( 5�3) (05 5 1^l 'z,� Residential bacidlow minimum . errnit fee: 536.25 );'hone: (5c13) t,p`j`� - 1 0\ Plan r eview (25% of permit fee) CCB Lie.: ����� plumbing Lie. yo.: \ (p 6 Slam surcharge (8% o permit fee) • TOTAL PERMIT FEE i.o. Authorized signature. 1 Date: 1v Z�'(Q This permit application expires if a' permit is Dot obiaincd with': Print name: 42.1..... + v1 (" at I �1 180 days at it has accepted h d ustsy Scrvic Bop 1. 'Fee mcttrod by oiogy set by Tri -Coununry ty Building in aaa- a6io vissi �/� U li eu: 3G1a ,�1Pcz,nioU'r.MF'Pennlr.A�.doe 14/x3 I CITY OF TIGARD • 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Y • Business Line: (503) 639 -4171 MST BUP Received Date Requested / '3/ AM PM BUP Location (o �a .� � �- - - % -&r Suite MEC Contact Person Ph ( ) PLM o7(x) q -T O v7 Contractor Ph ( ) / SWR BUILDING Tenant/Owner ( / — gaZ ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors /O (- a Ext Sheath/Shear O C)j 7L1H Int Sheath/Shear Framing Insulation Drywall Nailing ►y. �✓r� Tip d S�"' ° w.e'�• i/a` 1.,c 2� ° dt c �4, 0 V-9 Firewall Fire Sprinkler 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 Pan Other: 1 ' nal V 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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE - Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date i 13 ! / cS" Inspector d YA Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL