Permit A I CITY OF TIGARD PLUMBING PERMIT
l ft D EVELOPMENT SERVICES PERMIT #: PLM2004 -00031
r• DATE ISSUED: 1/23/04
13125 SW Ha Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10225 SW HALL BLVD 103 PARCEL: 1 S135AA 01901
SUBDIVISION: METZGER ACRE TRACTS ZONING: C -N
BLOCK: LOT: 037 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Rough -in & finish, (1) water heater, (1) hub drain for water heater, (1) lay & (1) water closet.
FEES
Owner:
Description Date Amount
WAYNE L GERIG OD •
10225 SW HALL BLVD [PLUMB] Permit Fee 1/22/04 $72.50
TIGARD, OR 97223 [TAX] 8% State 1/22/04 $5.80
Total $78.30
Phone : 503 - 244 -1004
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLND DR. #503
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone : 503 544 7464 Rough -in Insp
Top -out Insp
Reg #: LIC 120893 Final Inspection
PLM 34 -412PB
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: I / / / Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
I
Jan 21 04 03:57p Cascade Plumbing Co. RECEIVED 5032896699 p.2
jilir JAN 21 2004 - i c//?..0 3 -00 c,,q
Plumbing Permit ApDUi OFFICE FOR OFCE USE 0\1.1
�OF TIGARD gm 1125 W Tigard a a., Tigard. OR 9r UILDING DIVt81!� /.�� : I' li_.1/ . , .
Review
C�'iew „ _ /�
Phone: 503- 639.4171 Fax: 503.598.[')60 1
How Fta Other Permit N F (/O� r i, / �✓ T /
24- Ho Inspection Line: 503.639.4175 _ - I� Date
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o New construction ❑ Dandition For vadat Infame:lox use checklist
Description I Qty. I Ea. j Total
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cplacrrut 0 Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) •
L:1.£'.',izi;.z- fin Uklia. J s S +` - •Elpl I6 ?:' = 1 ' ,._ t > ``s5 SFR (1)bath 24910 -
❑ 1- and bfntilydwelling Commercial/industrial SFR (2) bath . 350.00 r
❑ Accessory building ❑ Multi-family SFR ( 3) bath 399.0 O
❑ Master builder ❑ Other: Each additional bath/kitchen 45
0
*_ _ - •;•,...;; l "ire sprinkler ( sq. ft.) Page t
_ 'ti` �;y�r is
91 ? .. ` ,F.. ' `: . ? I P I6 ' : 1 '=- .- .1 i s Site utilities
lob site address: 1 G •&s c 1),.) , 1 j ii /) Catch basin wawa drain 16.60
C ity/S te/Z1F: -- 6 � 0i . e_. CO u i ` i Drywall, leach lase, or trench drain 16.60
Suite/bldg./3FL DO /6 )• � ( f �_ ft.: ) Page 2
Mntufaclured home utilities 110.00
Cross satct/directiona to job site:
// Manholes 16.60
/-T./9 / / -1-- L C- L1 5 Rain drain connector 16.60
Sanitary sewer (no. linear IL. ) Page 2 .
Storm sewer (no. linear ft.: ) Page 2 _
Subdivision: 1 no.: Water service (no. linear fl.: ) Page 2
Taft map/earcel nm.: /6 /357919,_-"4"470° ( I A bso p on valve c•
,,.. ,. _- , .. Absorpdonvslwr 16.60
= t +i 1 3 kt ?St:D'P': b: , ,.a ^ 5:i .l`; . ;
's...;;, . .:,.-•;-i1:4:?. - .•Fl:r' 5":.,": lb . _ ... :,, r • � • ,, ... - ..� :i.5 HackOow pr/:venter Page 2 •
1- :s'Yhlm - ( i- 1 -`- - - t 6 ; S h Backwater valve 16.60
Clothes washer 16.60
Distrwsshcr 16.60
• r• r: . ,a 7 i _ :: r r -•F • • 1 . $ .- , Drinking fountain 16.60
u. $ _ a .,. i L5 �, a i.
Vii: iy:, = ` : : } ..: e Fec:: r *.. f3•• "... ect
• • E 16.60 0
Name:
� . .: I�I
A _ _ AI - Expansion tank 16.60
Address: Fixture/sewer cap 16.60 t'''
CitylStatc/ZIP: Floor drain/floor a' b I., 16.60 /6 LP �
Phone ( ) Flat: ( ) Garbage disposal 16.60 . -
f Fr i ` :i ' - „ r -�. .._ -•- :€ �': E3osc bib 16.60 • i° ice maker 16.60
Bexinessname c' K)C j, -'v) l A '1,:] ; t ' Ce C ) - Intrncptor/greasetrap 16.60
Contact name: (i-l- + -- ` L l) 10( - �) Medial gas (value: $ ) Page 2
Address: ZC a 10. 1`AA(. t'\`Qk\ .S l,i.(' k ],)C < n 3 Primer 16.60
City /Stare/ZIP: ?o ( -\ \", -A 6 1 ' Raof drain (commercial) 16.60
Phones: ( ,) J -- -� - /-7,,,,s Fax:: ( 3) 2s - Co 6c 4 �t Sink/basin/lavatory ! 16.60 f (c .Fri'
Tub/shower/shower pan 16.60
E-mail:
a y s. Urinal 16.60
.:t.: •;'ry+J_a )ii3 a'_ w *(
:i5 t��.4����,, ;;I.r!.i '�; >:iii.� •�i; R5
:,�:;..,- ...::,F� - -. '
' :� : : =.. �ii � � !� � \ iltt��_. -- ? ^Te .1: €-��'._�''•' .�.: Water closet /. 16.60 /Ca 0:0 Business tussl c- CAS C - Y 1 11..v--,\) i t.A F C Water beutut / 16.60 j(,„,. (,9 C.)
Address-1 '2, 0 L . • '. \ ( e� ∎ 3 Other: Subtotal
jV
City /State/ZIP: r. (-A \ .,\ . ! /
Minimum permit fee: j77.$0
Phone: (- ' ) L -7 4/ 6 L Fax: (S-/ 3) .2 y - (y (p 99 Residential baekflow minimum permit fee: 5)6.25 42.50
CC)3 Lic.: \ 2,c, g 3 a Plumbing Lie, no.: 3'-I -Li. I ? Plan review (25% of pcmiit fcc) g , I >,
State surcharge (8% of permit fee) - C)
Authorized signs • • ' . , TOTAL PERMIT FEE
Print name: '• - ` - - , Date � -2 `_ Thin permit applicator expires if a permit is not obtained within
180 days after it has been accepted as complete.
•Fee methodology set by Tri- County Building Industry Service Baud.
c\BwlitiaaVe shin .M,PartWePase inns 440.46161114102KOM/WEU1 Q
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 19 -3 l �O a Re•ue ed of 2 <0, AM PM BUP
Location /0 2 7 . / Suite l MEC
Contact Person i�rJ... Ph (1) 5W- 7 a-SS 0 " d 3 I
Contractor e¢d C a- / / • Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain //7 ?&'
Slab Inspec o s: 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
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
• -
X35! PART FAIL
CHANICAL
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: 0 Unable to inspect — no access
Fire Supply Line
ADA 2.
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NO REMOVE this inspection record from the Job site.
PASS PART FAIL