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Permit i 4 CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2003 -00602 13125 SW Hall Blvd., Tigard, OR 97223 (500'639 -4171 DATE ISSUED: 11/24/03 SITE ADDRESS: 09430 SW CORAL ST 150 PARCEL: 1S126DC-04400 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P BLOCK: LOT: 007 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Add (1) sink & (1) water heater for TI. FEES Owner: Description Date Amount RENAISSANCE DEVELOPMENT 1672 SW WILLAMETTE FALLS DR. [PLUMB] Permit Fee 11/24/03 $72.50 [TAX] 8% State Surchan 11/24/03 $5.80 Total $78.30 Phone : 503 - 557 - 8000 Contractor: CRAFTWORK PLUMBING INC 7736 SW NIMBUS AVE BEAVERTON, OR 97008 REQUIRED INSPECTIONS Phone : 644 8698 Rough -in Insp Top -out Insp Reg #: LIC 79666 Final Inspection PLM 20 -148PB 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 Issue By: . ,` / /' �! Permittee Signature: /// .),,,A1/ d�a Call (50 ) 639 -4175 by 7:00 P.M. for an inspection needed the next business day ,p oo 3So �" ') 7 tU� 2m � _ Plumbing Permit Application OFFICE USE ONLY . Date received: # A G3 , 4 Permit no.: 6 �J 1- t����- City of Ti gar t . ') IV p Building permit no.: Y g 1♦ Sewer permit no.: Buildin Address: 13125 SW Ha .l City of Tigard Phone: (503) 639 - 4171 - . Project/appl. no.: ..ire date: Fax: (503) 598 -1960 NOV 2 0 2003 Date issued: B ,/ Receipt no.: Land use approval: CITY OF TIGARD Case file no.: - Payment type: . TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessoryCommercia]/industriai 0 Multi family Tenant improvement ❑ New construction ❑ Addition /alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: ` l i f 3 0 s u/ Cora Description Qty. Fee (ea.) Total Bldg. no.: I Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: IBlock: Subdivision: SFR (2) bath Project name: Harlin greP oe /14-, SFR (3) bath City /county: 7'• ZIP: Each additional bath /kitchen Descfiption and location of work on premises: /1114/ rMNk Site utilities: 7.1 Catch basin/area drain Est. date of completion /inspection: -QY Drywells /leach -line /trench drain PLUMBING CONTRACTOR • Footing drain (no. lin. ft.) Manufactured home utilities • Business name: ri orK %al • Me- Manholes Address: 7y 1 ybe ;M�jv Rain drain connector City: Jip�- n I S tate(oR I ZIP: q we c Sanitary sewer (no. lin. ft.) Phone: GC 4,7... ff,kFax: y ,ieE -mail: Storm sewer (no. lin. ft.) CCB no.: '796 Plumb. bus. reg. no: .19 p. /de�Water service (no. lin. ft.) City /metro lic. no.: Z,S'o/ Fixture or item: Absorption valve Contractor's representative signature: Back flow preventer Print name: t /' 'p/ 6 • Date: I ' -►03 Backwater valve CONTACT PERSON Basins/lavatory washer Name: ll crlh�s I �G ,ea Dishwasher Address: Drinking fountain(s) City: I State: I ZIP: Ejectors /sump • Phone: 5 1.. 1, „, Fax: E -mail: Expansion tank • OWNER Fixture /sewer cap Name (print): & l f fan // 6 G rb drains/floor sinks /hub Hose bibb disposal Mailing address: • Hose Bibb City: I State: I ZIP: Ice maker Phone: ,5,r°7-•• MI Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular rain (commercial) j� �/�'� employee on the property I own as per ORS Chapter 447. ink , basin(s), lays(s) , /G.`^ Owner's signature: Date: p ENGINEER Tubs /shower /shower pan Urinal Name: Water closet Address: Water heater 1 ' 4,(,O City: State: ZIP: Other: Phone: Fax: E -mail: Total 3 ?Ja Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $ 7a sV Notice: This permit application %) i Plan review _ $ ❑ Visa ❑MasterCard P (at ) expires if a permit is not obtained e go Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ .- Expires TOTAL $ 7g 30 Name of cardholder as shown on credit card accepted as complete. Cardholder signature Amount / 5/ , � j --©/ A6Q 440 -4616 (6 /00 /COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Oz_ Date Requested / ' 3/0 S/ AM PM BUP Location ? "T () l n712 7J �7� Suite MEC Contact Person Ph ( ) 425 _ i0 . Z_ Contractor // Ph ( ) SWR BUILDING Tenant/Owner �>-9-:kY- /.fit' d q/ ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain / Slab Inspection' Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing i Firewall Fire Sprinkler Alarm _Ip7r Susp'd Ceiling Roof Other: I , Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan PART FAIL CHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRIC A L 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 r1 Approach/Sidewalk Dat ( 1 Inspector Est Other: Final DO NOT REMOVE this inspection record from the job site PASS PART FAIL