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Permit ,, C I TY O F TIGARD PLUMBING PERMIT a ,,i DEVELOPMENT SERVICES PERMIT #: PLM2004 -00556 Ails 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/13/2004 SITE ADDRESS: 11625 SW BURLCREST DR PARCEL: 1S134CA 04700 SUBDIVISION: BURLWOOD NO.2 ZONING: R - 4.5 BLOCK: LOT: 020 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: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: 30 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replace existing water service from meter to house. FEES Owner: Description Date Amount HOLMAN, MICHAEL B 11625 SW BURLCREST DR [PLUMB] Permit Fee 12/13/2004 $72.50 TIGARD, OR 97223 [TAX] 8% State Surehan 12/13/2004 $5.80 Total $78.30 Phone: Contractor: NORTH'S PLUMBING 17120 SW SHAW BEAVERTON, OR 97007 REQUIRED INSPECTIONS Water Line Insp Phone : 649 Final Inspection Reg #: LIC 340 PLM 34 -18PB 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: P,p Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day FROM i Nort.i,s+FSC FAX NO. :5036495544 Dec. 13 2004 12:08PM P2 12/13(2004 1u00 FAX 50$3981860 CITY OF TIGARD lij 001 ;... N. ... . .. . . . . , .. • . .... . . . .• ' • ' .• . , ••.*:''':.•'..-....'......."::: :-.'.'• :t:;' ,':''..•'':....'.' .::'.. '. '•:',.'L .;,,. -", ...it: Plumbing Permit Appi ,,.i I . c.', I E.0 . • . 1.01i .0 I. l'I(..F. A .$ C. 6NII.N' . .. : .. • • : . •.....CIty of Tigard • • - it....!.ivt,i ...1 ' . - ...)..pikit.;.; :....C...W; 't • -6 ' 13125 SW Ball Blvd., Tigard, 0 • 9 ' i 3 f0°‘ PhD RetieV7 Phone: 503.639.4171 Fax; 503-598-1960 ,.... A "N , . , ,s1sgt l i., ,, 2.11,AGASN t C diere t tintt No.: 24- Hour Inspection Line: 303.639,4111 . vAl c. , N, 3-• i k ap,.:,....F4. - i i ......,...., 6:,,,•„...„,,,,,„ 1,, Ri ban Po;c 1 ror Internet: www.el.ttgantorus . Lt:Leet , , , , .. . _ 1 Supplcruntitol Information . M,.::Al:'ti*, :. li••,..1i Iiii :1 ,:.,' q. i: •", c .! si .C', : 00,:*0 1 001 : 41 : . •... . ... L. • . • 0 N oastraellou 0.1 , ri Dw ---.......„„..,,,- o„ • . .. • ' . - - • . - Forgpcgial iltfonnettivi we checklist , Thow,Tiption - f Ply; 1. • -ET -rcii , 1! Additiontalturutionirepliweasent 0 Ocher: New 1- 2-family ilweil1t4c (inCludeS 100 ft.. ibr each utility connection) ... . 1...:{ l i ''. : 1 40.*.*ri . :;.i''•:Ck ' . '•. • ''"? .: • • ..: SFR (I) ball 249.20 -..- t! 1- ond 2-fornity dwelling El ObrumercialAndustrial SFR (2) bath . 350.00 SFR. (3) bath 399-00 EI Aaces7 soti.iding 0 Mu iti- finilY .- Eac additional barblicircbcn 45.00 0 Master buiWer ID Other; , . ,. , . ... . , Fire sm.:elder (.._,.. sq. to 1 2 -- ,- 'i,,,./... **0 .,• l 'n • :: •.' '.• !, qi adagio . • • • - _ lab site 43�s: - 5 . / .0)5 I . e . , Cad: blitilTI Dr 11161 drain 16.60 ; , ryw, leach line, or trench drain :6,60 City/State/IfYi" e Argri ' ;2 - - Dell - . --- rcroCing eltAilf (t1Q. linuat ft.; ) Pesc 2 --,,--„,......--• Soitelyldg,lept. lie ' Prejeal name: ----- • .. Av mornAeznred home utilities 1 1 OSA , ,..... a: .- , . . ennui ateet/dirCe6011S to jab gift: ... ar a . 4.... AV' . 14,: . lien 16.60 1_,, . • " - Marktieri '4 / -- . ...., . RobilArnin connecter 16-60 - Sanitary sewer (no. tinter ft.: : Page 2 . Storm sewer (no. Iinev ft.: __) 1 1 Page 2 - --r----7 - - , Winer fiery= (no. lineor Ft: __) , Page 2 Subdivision: I Lot no.: ._ - ---..-- Fixture Or itorn Tax mup/parcol no.: ---- Absorption v 6 alve 1 , '.. • • •• , ,•• • , !.,: • .. ••••:•• . '':::' • '.:, ttr,SCRIFO a N. OF a ' • .... ' ! •' • • • • " i: : '• ' ' 4 ' Baclerlow preventer Page 7- - - ..--7 - ..1 • 2.... Backwater valve 16.60 ,„ .. ......2 ....' --' - • 2 *V ' - . .., AV - --; / Cliattirs washer 16.60 • • " ar'...0 aflir.-Ley-.0 • .-" , . Dishwasher 14-60 , • -.-..---- . . . Drilling fountain 16.60 -1 ... L•'' -': .'' ,:.: ' ,:1: '' '• .:!"...'''..:'q-13 .. ''''..: '' ••••• • .... " I 1 Ejectors/sump - -- 1660 i • Name: . ■ . /1.. ,. r.xparision timk 16-60 - - 162.43 i--- • ..- ./ , Addressy77 Jai- 40". „_, "I .• / . .: AL i Fixture/sower cop ; , . 1 I Floor dridn/floor cinlehob 16.60 City .../ p , , ,, , , 9 ; u w. _ . . _ , i....___ ) _______ . i : Garbele gispoml 16,60 ; Phonct iI, . ti" ' ')- ,, ,,,O0 -. PaX: ( ) ' ---; . .. .- . : . • • • • . ;-'''''.- ..,-- I Hose lifo 16,60 ....: ,i • -,!::,.. -,...-, ,t • "....-r- ".. 04''1d .ijr::11:4; ... I • ' ;.!•rj; : '',Fdi.itier■ . :fritgo,4, , . . : . I. - - t tpi,....7,t, ...Y. .. ■•F'.•.4 1‘ : • , ' ■ ' . • ' I: • .. ' • • A. '' ,-.".. :. • ' • - •• . ' • • -• 10 ma 16.66 Affer. ..' . MP." B I uineas n am e : ,:, Ar ...a:t..,..'1. ' ' vane trap 16.60 -- -----__! „ .... 1 Ifilaraptougi Faze 2 Contact name . _ : _ f . t ? frIcdical $11.4 (,31Le: 5 ) _ -- - i __. 16.60 Addressi ' ' 1 Primer ...--, . rioof draln (commercial) 16.60 City/State/ZIP: •.... I . ...A. i PI ......- 1 "'''''' on..,,asewevera-s 16 • • Planner ( ) . ( ) ..mrwro. ■11. , •••--- Tubishower(shower pars 16.60 E - mail: Urinal • 16.60 -.- . , 'iii '....'•.' •:..."1'I:ii !.1:1: 'z • : :66 , ,-.. cre.*: • ,, i ,.:.. i:;;H: ':.',',:' ,• .. i, .., :-. -. ' ... ::., Wnwr closer 16.60 ...1,:'.;r: n',..:7. • .; '-... : i•.,.!r•:' . r..•:.!. • • . ..- ater Busin er ess name: / a , ,,4 , A r 1.e.--/- :,. . __ZA2.>, - _ w heater 16.60 Alicirces_ y , O , ..' Ott: 17 . - ------ . _.. " Subtotal 55 ---' i___ Ast ........./ .41' '.i:?" " Minimum permit (ee: 512.50 Pktea= _400 ..„ 4. • 46.,. „AM Fax: ar: ).. e' ..- - f45)(0/95 112,218ent4.11arielef1aw mini num perrnit fee: 136.25 -I CCEI Lie.: 09,31/0 ,figairmippr .-,.._,._.-,,iy-i? ---- Eon review (25% of permit Ste) Sono um-large (8tra of perrnit fee) Autharizecl signatlirCi MP 11111111M ' Torni. PEIIMIT .r Print name: i f i rt : ai _ L . ,,,, 1 . Date; J _ 0 7 Tab permit nypLicati ires on exp If 11 permit Ia not obtain44 wit in 1Rtr days after it ban been accessed as crumPtete. *Pee T set by ,'d-County Building industry Service acad. /.4.114,4.4.notkpLat.pyi. dc.. leAu .cao-4 itier(10/02/CONCAvgal 7c22 • . - .. . .. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business tine:, (503) 639 - 4171 MST BUP Received ` Date Requested /- (6 AM PM BUP Location Suite MEC Contact Person 1'LJ Ph ( ) 4fq - 53 ' PLM cO l) L / — ao,.S� Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation .Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: /} SIT Post & Beam / 3- - 3 Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Fire Sp Fire Sprinkler Fire Alarm Susp'd Ceiling Roof �► � Other: ��- Final PASS PART FAIL PLUMBING /� G j���? %� < - p Post & Beam Under Slab Rou h -r �� ate Se 1 (7 - ‘1 - 2, - Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain • Shower Pan Ot 40- Af . —1 AO/ i PART FAIL spa.. ECHANICAL 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 / / ✓/ s o P Approach/Sidewalk Date Inspector Ext Other: l Final DO NOT REMOVE this inspect on record from the Job site. - PASS PART FAIL