Permit „' ``P CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00305
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/22/2007
PARCEL: 2 S 102 BA -02000
SITE ADDRESS: 12353 SW GRANT AVE ZONING: R -4.5
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT: 045 JURISDICTION: TIG
PROJECT: GRANT STREET ELITE CARE
Project Description: Site utilities to include (1) manhole.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: SR1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 2
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 155 ft
WATER CLOSETS: WATER LINE: 150 ft
DISHWASHERS: RAIN DRAIN: 335 ft
Owner: FEES
ELITE CARE
2300 SW 103RD Description Date Amount
PORTLAND, OR 97225 [PLUMB] Permit Fee 6/19/2006 $381.55
[PLMPLN] Plan Review 6/19/2006 $95.39
[TAX] 8% State Surcha 6/19/2006 $30.52
Phone : 971-506-0151 [PLUMB] Permit Fee 3/22/2007 $111.65
[PLMPLN] Plan Review 3/22/2007 $27.91
Contractor: [TAX] 8% State Surcha 3/22/2007 $8.94
RANDY ROGER PLUMBING Total $655.96
PO BOX 350
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #: LIC 168668
PLM PB277
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 or 1.800.332.2344.
Issued By: o /1IL I � Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business: day.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
rir CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2006 -00305
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/22/2007
PARCEL: 2S 102BA -02000
SITE ADDRESS: 12353 SW GRANT AVE ZONING: R -4.5
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT: 045 JURISDICTION: TIG
PROJECT: GRANT STREET ELITE CARE
Project Description: Site utilities to include (1) manhole.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: SR1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 2
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: 155 ft
WATER CLOSETS: WATER LINE: 150 ft
DISHWASHERS: RAIN DRAIN: 335 ft
Owner:
FEES
ELITE CARE
2300 SW 103RD Description Date Amount
PORTLAND, OR 97225 [PLUMB] Permit Fee 6/19/2006 $381.55
[PLMPLN] Plan Review 6/19/2006 $95.39
[TAX] 8% State Surcha 6/19/2006 $30.52
Phone : 971-506-0151 [PLUMB] Permit Fee 3/22/2007 $111.65
[PLMPLN] Plan Review 3/22/2007 $27.91
Contractor: [TAX] 8% State Surcha 3/22/2007 $8.94
RANDY ROGER PLUMBING Total $655.96
PO BOX 350
REQUIRED ITEMS AND REPORTS
Contact # :
Reg #: LIC 168668
PLM PB277
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 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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lumbing Perm Application FOR OFFICE USE ONLY - $ ; w,
s ,
City of Tigard Received / 2 / Dh yyyy ,rrr � 7777 permit No • 7� f
y ll Date /By: / 3 ) h.n1j20b 0030,
13125 SW Hall Blvd.,- Tigard, OR 9722 �k�' 'VF--7) Plan Rev w
Phone: 503. 639.4171 Fax: 503.598.1960 / ; lit, +A Date /By: /2 Other Permit No.:
24- Hour Inspection Line: 503.639.4175 I X Date Ready'/ : / / /g/(1 Js to See Page 2 for
Internet: www.Ci.tigard.or.us 1 • • I Notified Method: �j / � � * �supplemental Information
j : 4 : ' TY PE ": l'ORKr ,I. ' ,, 4 , , FEE SCHE ► g E
New construction RI 11 o • lo re For special information use checklist.
DT,`' e(oN / , / Description I Qty. I Ea. Total
❑ Addition/alteration /replacement ❑ Other: New 1- 2- famil dwellin (includes 100 ft. for each utility connection)
j: a �a , = .•
:� :CATEGOR•Y .OF,( ONST� RUCTIOIY ` - SFR (I) bath 249.20
°° - =- Via. _ ,� : - r . �, „- .. x m � .,. •., .. r3o+a am --a,44* - 21 i-i_�;� _
. ❑ I - and 2- family dwelling . ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building Multi- family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other: Fire sprinkler 2
- - - - -- - " ire spun er ( sq. ft.) Page
- s- :. - JOB. -.SI INFORMATION AND= m om , b Site utilities
Job site address: / •Z 3 L-/-- 5 G 2Asf\V S - 1 Catch basin or area drain 2- 16.60 33. 2,, ),
City /State /ZIP: 77 fr'a2, Drywell, leach line, or trench drain 16.60 1
Suite/bldg. /apt. no.: Project name: 0 LI - 7 E Cq2 r FA eu ..r r- Footing drain (no. linear f .. ) - Page 2
f Manufactured home utilities 110.00
Cross street/directions to job site: l� • �1 8 s e, .� S t� 6 ,. 1� 7
L-] Manholes ' 16.60 i� . 0 /k
f2vr1 //) T e 2 (o 67) ON � 1 - 7 L4 Rain drain connector 16.60
S h) -d_ gzV 6 (J Sanitary sewer (no. linear ft.: ) i f 6' Page 2 4 . _ ' \ Q/
Storm sewer (no. linear - E.: Page 2. /40 q 4
Subdivision:' Lot no.: Water service (no- linear ft.: ) /50 Page 2
Tax map /parcel no.: a s 0 Z 131-1 J D 2_000 Fixture or item
Absorption valve 16.60 44 , kitID f ' - F fi , � , DESCRIP ION= OF WORK g 5 ,a „ Backflow preventer / Page 2
5 i 1 h `P L_ J M j 0., & 0 >2 7 Backwater valve 16.60 .
�� � f i� l ) r� Clothes washer 16.60
� Dishwasher 16.60
.. ROPERTY= OWNER ` " ❑ ENP NT - Drinking fountain 16.60
r -- - Electors /sump 16.60
Name: r:- . ef 'i ,
Expansion tank 1 16.60
Address: "2-1-÷- 0 ( E M L- s R.._ & L_._.i 1S , ,j ; Fixture /sewer.cap 16.60
City/State /ZIP: .<j _TL_A,\)C> Q f c-177,1-1.-- Floor draiiilfl61Sr sink/hub _ _ 16.60
-N � p� • G ar b age di 16.60
Phone: (5'03 ) 2. 8 Z- t / q Fax: ( ) / ` .. ;
.,. $- Hose bib / ���P ' I F
; APPLICANT r e C O NTA CT PER SON
� -- . ��� Ice maker 16.60 .
Business name: C A Interceptor /grease trap 16.60
Contact name: L) I L__`1 A (LC 1 Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
�-� Sink/basin /lavatory 16.60
Phone: ( -O ✓vb
e0 . Fax: : ( ) • Tub /shower /shower pan 16.60 -
E-mail: /
_ r Urinal 16.60
tea. „ r' €ONII'tRAGTOR 3lik t' 1 ol t' / -) Water closet 16.60
Business name: / 1 ( / / Water heater 16.60 lif3 it y,
Address: / Other: Iy�
Ci /State/ZlP: Subtotal ,3 w , S S
ty m M 1 ' Minimum permit fee: $72.50 /A3-1C,..,
f
Phone: ( ) a _ .2 -1,∎ I Fax: ( ) � Residential backflow minimum permit fee: $36.25 4 *.
�� ^ iX Plan review (25 %of permit lt ). ' ... "1
CCB Lic.: .:_' __ ` t r Plumbin Lic. no -:
� � g % l � _ ` State surcharge (8% of permit fee) -
Authorized signature: L0r!s
g _�A i/ 1 P bA '/ 7 � /c " T 3 op TOTAL PERMIT FEE 57:) , ID
Print name: / ��� 40 / Date: This permi a ppl catiio expires if a permit is not obtaine w n �j
✓ / 180 day after it has been accepted as complete. ="-� L° '1
/c2 *Fee methodology setby Tr Countty Building Industry Service Board.
i.\ Building \Permits \PLMPermitApp doe 06/05 ( (/ 440- 4616Tt10 /02 /COM/WEB) I V ( -. I I � 1 ry"U QS 0 ! 7 or! a Y/�'��
•
CITY OF TIGARD ,..
,
1111111
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'
BUILDING DIVISION • * . .
PERMIT #: PLM2006-00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 322j)7
Phone: (503) 639-4171 t
Inspection Requests (24 Hrs.): (503) 639-4175 ,....
INSPECTION WORKSHEET FOR DATE: 2/19/20013 TIME: 7:01AM PAGE: '10
SITE ADDRESS: '12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Site utilitiet to include (1) manhole..
OWNER: ELITE CARE, PHONE #: 971-506-0161
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: - N 19 / 2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
322 Shower pan 065212-02 971-5061973 Y
Corrections/Comments/Instructions:
1t v ei,A...__6;_, ee./....1 PLI V1 200G- 004 2-S
n PASS fl PARTIAL APPROVAL IQ CANCEL 0 NO ACCESS
I I FAIL Li CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: (1 - 6 \11 1-A-J ‘ i' \l'I'''' Date: "2—\ \a\ krt Phone #: (503) 718-
CITY OF TIGARD
,•
BUILDING DIVISION PERMIT #: PLM:2006-00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/21/2007 TIME: 7:03AM PAGE: 48
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Site utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971-606-0161
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 12/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
322 Showei pan 062028-01 971-506-1973 ¥ p
Corrections/Comments/Instructions:
0 ..,„11 - Pl. M ,t, 00
(U -1 ct -4-e/ 1 ;.rai L
El PASS PARTIAL APPROVAL CANCEL n NO ACCESS
I I FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: Date: 12-124 (Y3 Phone #: (503) 718-
CITY OF e
�*um n m�pn TIGARD
BUILDING DIVISION PERMIT PLM2006-00305
~~~~^~~~~^^~~~ ~~^ ~ ^~~~~~^~ #: ' ~~
13125 SW Hall Blvd., Tigard, OR 97228 DATE ISSUED: 3/2I/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7y8/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE.
DESCRIPTION: Sit utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971'506-0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 7y0/2008 ' Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 072314-02 971-506-1973 N
Corrections/Comments/Instructions:
QA^°e,
•
•
PASS �� PARTIAL APPROVAL �� CANCEL | | NO ACCESS
/ / / / / I
| I FAIL [ | CALL FOR INSPECTION [l ADDITIONAL FEES ASSESSED
/�� �\�_� � ��|���
Inspector: `^ ° v�«~^-�� Date: ^ / ~ / ^ • ' Phone #: 8503\ 718'
r )
CITY OF TIGARD t .
ot
BUILDING DIVISION PERMIT #: PLM2006.00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
4li emai mp lt '
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 502008 TIME: 7:01AM PAGE: 19
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREE I ELITE CARE
DESCRIPTION: Site utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971-506-0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 5/8/2008 Pour Time:
Code # lAection Description Confirm # Contact # Message
399 Plumbing final 069595-04 971-506-1973 N 4'
Correctio es/Comments/Instructions:
1.44-A Ar , ... , , .
v'
h. Al lb LAM' •
< 4 • i -....___., I
- IP
L.sl—r
I 0 4 .,( _ ___, '
1111 -
7 PASS \ PARTIAL APPROVAL 7 CANCEL El NO ACCESS
7 FAIL 7 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: VA g-
Date: r/r/ t' Phone #: (503) 718- 2,42-'1
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CITY OF TIG si * pLwi2oob-oo3Qs-
IUTILDD G DDVOSMN PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 f'i ?. 3(
Phone: (503) 639 -4171 P1■1*
Inspection Requests (24 Hrs.): (503) 639 -4175 _.-
INSPECTION WORKSHEET FOR DATE: 412a'2O00 TIME: 7:OeaAivi PAGE: 5
SITE ADDRESS: I "_` r SW Gt ANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARL EXTEND RE LOT #: 04C TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE •
Plumbing s 2 i f 3 8 �. 1: . k C' St R
DESCRIPTION: ! K;a� °��I��r•�.f ti;��Ia : =•t.� .��I,��:�r fi,�,t�.�E� =��, 2 primer., 1 ,�:n��t:�R�_�a;, �1 t�:��,�e, ��il`iyan 2 �:�,;,:a��<sis°: >;:arer:.�, Grant ,_ `Yr.t
Etito Care. 02/1460.1 added (2) dis i•aa .he,
OWNER: ELITE CARE PHONE #: 0.1-. €05.01
CONTRACTOR: ROGERS PLUMBING, RANDY PHONE #: EtK1-66t 0(1
Inspection Request Scheduled For: Date: 4/29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
a.•i: Plumbing final mama 01 !til-- 606,1972;
orrections /Comments /Instructions:
' 1��. PL 20c3C 00365 Coo i rot S P1 ;������,.
49. �I vo+l: l./'J ='J eX e, et6. -v eoz �eA:'t .1u, 4/ i- 4- r0v02 -A:
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-'� : is I -4 % ! � ��,ve' _� - 06. b _t.� _�►c_t I� 11 e � Gc a..�c> � -�r_i_ _ �`.�v c --�-c w. yJ
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PASS PARTIAL APPROVAL n CANCEL NO ACCESS
►1 FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date: �,�C k Oil) Phone #: (503) 718 -
r
CITY OF TOGA' t .- 1 , A 700 , 700 - ° C/3 0 .
BUILDING ®BVOS� ®I PERMIT #: — 434)4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/ 4 2C7:)t r
Phone: (503) 639 -4171 . i
Inspection Requests (24 Hrs.): (503) 639 -4175 t' rig' i�
INSPECTION WORKSHEET FOR DATE: 11/2/21007 TIME: 7 :01A M PAGE: 2
SITE ADDRESS: 12',',G) SW t GRANT AVE CLASS OF WORK:
SUBDIVISION: GRAN AVE ELITE CARE '1 END RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: New re :ic ntis i calm facility
OWNER: ELITE CARE, PHONE #: 971
CONTRACTOR: R 4 R ENERGY RESOURCES PHONE #: 97'i- 506•0Th I
Inspection Request Scheduled For: Date: 11120007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
•
• 310 Ct Mt chain t }f'?e92 T- 01 97150E; -1973 i ' N ,`
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Corrections /Comnen nstructions:
C�,.�.,(A \ S - — -- �,
4 , c \
s ,i \o
Li
, \
. ,A-1 1
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I I PASS PARTIAL APPROVAL CANCEL NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED -Z-
Inspector: s (' ✓ Date: I, 1/7/45') Phone #: (503) 718-
, t= -
CITY OF TIGARD • r
BUILDING DIVISION PERMIT #: m0006.00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone: (503) 639-4171 4r i j j l �
Inspection Requests (24 Hrs.): (503) 639 -4175 I_..
INSPECTION WORKSHEET FOR DATE: 10f1 2/2007 TIME: 7 :01AM PAGE: 4
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: TYPE OF USE:
PROJECT NAME: GRANT STREET I CARE:
DESCRIPTION: Site utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971-50G-0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 101/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 05754011 971- 506 -0151 Y
Corrections /Comments /Instructions: pp p�
J Wb G�,�vl?� -�r q jt OIAi dJ v' Ca �'e - � q" 43c.4' ak
It' V fi� S 6 e S �v .�,-� L% " Tb 6" ft....;
73 g ff Via, l'1 -‘e1 ,
PASS PARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL fl CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: '�' ^- Date: / 6 p, .l7)7 Phone " #: (503) 718-
- - - -;"-. - •
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CITY OF TIGARD
BUILDING DIVISION : PERMIT #: PLM2006-00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone:. (503) 639-4171 pholiill
Inspection Requests (24 Hrs.): (503) 639-4175 i
INSPECTION WORKSHEET FOR DATE: 8127/2007 TIME: 7:00AM PAGE: r
.D
SITE ADDRESS: •2353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Site utilities to include (1) manhole,
OWNER: ELITE CARE, PHONE #: 971-506-0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 8/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 054691-01 971-506-0151 N
Corrections/Comments/Instructions:
2 " t..),---h<re...,, 1 4,-(... 11: k I P. Rine e r(A„ - t . ke_,j, ii,- j 4.1 ---
L.: .4.-c
. . •
Cgf PASS I I PARTIAL APPROVAL 0 CANCEL NO ACCESS
I FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: eV ti / \ f\--- Date: 5q2 Phone #: (503) 718-
.. _ ,
• .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006- 0030&
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone: (503) 639-4171 hput flli
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/13/2007 TIME: 7:01AM PAGE: 5
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Site utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971 - 506 -0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 8/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 053875.01 971 -506 -0151 Y
Corrections /Comments /Instructions:
c4. \ c.x) j It g LA ,.--� o'i -c.0 I „ L, j 1lt,"....b 1,, g'I / y ) 07
, 2 Li ' Out,/ cl,ow t i... -. rV -- D Ae p :, ,� .,,d (6 b i., , t 0
42.- 1 ,- ti) D1- 94 ./ e -a ,
9 ' ' !I` o, ; F (---) c v L L; t..,e_ 1 9 0' Ok oval Zi.. -e z.) (c 6i CJ mist c,. -1 H!
PASS % PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL n CALL FOR INSPECTION I i ADDITIONAL FEES ASSESSED
Inspector: (IU Vim L.J HI I+--- Date: Phone #: (503) 718-
., .
- -1
CITY OF TIGARD
BUILDING DIVISION . ..'A PERMIT #: PLM200G-00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/20437
Phone: (503) 639 -4171 iibpikliii
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/4/2007 TIME: 7 :01AM PAGE: 34
•
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Site utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971 -506 -0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 6/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
395 Misc. inspection 049520 -01 971 -506 -0151 N
Corrections /Comments /Instructions:
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F4 PASS I I PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
V .° r 1 Inspector: v ill `'� Date: t ' Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2006-00306
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/22/2007
Phone: (503) 639-4171 41010
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/23/2007 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Site utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971-506-0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 5/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain . 048920-01 971-606-0161 Y
Corrections/Comments/Instructions: d/iCif4r
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Inspector:144 2 (/ Date:3/93/9Phone #: (503) 718-
CITY OF TIGARD R
BUILDING DIVISION = . PERMIT #: PLM2006.00305
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3122/2007
Phone: (503) 639 -4171 ■ m ' di�iht61 ii
Inspection Requests (24 Hrs.): (503) 639 -4175 . al' 111.
INSPECTION WORKSHEET FOR DATE: 5114/2007 TIME: 7:01AM PAGE: 62
SITE ADDRESS: 12353 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: GRANT AVE ELITE CARE EXTEND RE LOT #: 045 TYPE OF USE:
PROJECT NAME: GRANT STREET ELITE CARE
DESCRIPTION: Site utilities to include (1) manhole.
OWNER: ELITE CARE, PHONE #: 971 -5061. 0151
CONTRACTOR: RANDY ROGER PLUMBING PHONE #:
Inspection Request Scheduled For: Date: 5114/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 048174 -01 971 - 506-0151 N
Corrections /Comments/ Instructions:
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PASS n PARTIAL APPROVAL n CANCEL NO ACCESS
I i FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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nspector: � Date: L /� Phone #: 503 718- .2/