Permit CITY TIGARD PLUMBING PERMIT
'" ".rT'£lk DEVELOPMENT SERVICES PERMIT #: PLM2006 -00376
�.� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/9/2006
PARCEL: 2S104AA -90162
SITE ADDRESS: 12658 SW KAREN ST 16 ZONING: R -12
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUMS LOT: 016 JURISDICTION: TIG
Project Description: Install clothes washers in units 16 & 17.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: 2 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: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
MOZINSKI, STEVEN P Description Date Amount
ZAKOCS, EDWARD JR
PO BOX 189 [PLUMB] Permit Fee 8/9/2006 $72.50
YAMHILL, OR 97148 [TAX] 8% State Surchan 8/9/2006 $5.80
Phone : Total $78.30
Contractor:
R D PLUMBING INC
13900 NW SPRINGVILLE RD REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97229
Contact # : PRI 503- 297 -7422
FAX 503- 297 -7344
Reg #: LIC 73913
PLM 26 -313pb
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
requir9..s- you rules adopted by the Oregon Utility Notification Center. Thowe rules are set forth in OAR
952 001 -0010 throug 0A 952 - 0001 -0100. You may obtain copies of the _ru.lesor direct questions to OUNC by
cal ing 503-246-6699 or 1 0- 332 -2344. ;
Iss ed By: K._ )fL Permittee S
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.
1' O01/2013 18:21 FAX 5032977344
( 10.,
.,... RD PLUMBING 2002/002
. .
Plumbing _Permit Application FOR OFFICE USE ONLY
City of
t31'SW Hall ig 13Ivd Tigard, OR Tard ECENED ilcceivcd
olio itesiew ,,
Daw • • • 1011 Iv 1. 1" tq '' • Il Lt/9e 1. 6 663 7 6
.5 .. 072R
Phono: 503.639 , I I 7 I raN: 503.5 It)(10 Dnic it))- ( nlie, no•nni Nu,:
i '
24- t-lour 1nm Line: 503.639.4175 puG 8 200c&g. All * F.
),„.Ke.i.yiny. - 4,-- - - --- 0 se, Nut: 2 for
t I Itentet: WWW.Ct.t lattrd.or.us Nul i nCti/M ;JAM!' ' 10 StIppienivntAI Int lion
--- .----
TypE eiiiN-NIWITI'L3/Anrr-7-. * sciiF.011.1
___,
, -
For,pecial inforintillim IIN(' elfrrkli
0 New construction a 611-3: "‘
Description 1 Qty. I En. I Total
utilits ..
R ,4dditionialteration/replueement 0 Other 2.Nolib dwellings ( imitid eS I On II. lin crich ' connection) -
CATEGORY OF CONSTRUCTION sFR r I) bath 149.2(l _
- - . __ ••••-• - ••• '
0 I- mid 2 fatnily tlsvelliq,, Vcommereial/industrial SFR (2) hath 3511 :fill
- • . '-'•--- - • '' Si' k (3) bath :t991)(1
0 Accessory, building ID Multi•ramily .. .
_ -. - I Elci) additional bitilt/kilchen 45.00
0 Master builder . 0 Other: _.___ ._ .
- - Fire prinkler ( sq. It.) paf?.e. 2
JOB SITE INFORMATION ANT) LOCATION •
Sire utilities
._.-
--•------------ . . • . _
Job site address: i II t . .5, ta , Catch basin or mei) drain I 6.(n)
_._ ___.• ._.._.._.
City/State/ZIP: , . v .____..._. _ Dry‘k 11 II i el. 42:1C InC. 01 I wnch d min
. I
6.60
-._ F (train oto. linear It.: ) Page 2
Suise/bldglapt, no.: rojeet name:
- ' - • . Manufactured home utilities II 0.00
Cross slrectklireci ions to job site:
Manholes 16.60
-- - . •
Rain drain connector 16.60
Sanitary sewer (110. linear R.: ) lane 2
_ ..
- . ._.
• - _.. - . ' Storm sewer (in'. linear 11 ; ) Page 2
, • ..
- - Water servidc (no. linear It: 1 Page 1
Subdivision: • Lot no,: .
,
- _ Fixture or item
I'ax map/parcel nO.:
_ ,.--, - Ahsurption v a) VC: I 0.60
DESCRIPTION OF WORK ' • - . •
Pap.c 1
1 now PrevellIcr
_an 4 1-170 ■S . fift A ...1 ---. ±1- II --11- Baelo■ ma valve I 6.60
Clothes washer -Z• [0.60
-
--,_ -. • _..-- ,_, . •
vishwasner 16.60
>
-• • • Drinking roliniziii) • 16.6o
lal/fROPERTY OWNER _
Nam
`'...4 simarkp 16.60
.
‘7---&[611T4C1 ..es-itillIff.i.--4(..0 ... 4.11 ''-' - Ejector..
EN plum 011 SIMI. 1 6.60
--- . Fix,,:„-ch,,,,,, - cap - - .
' In ) ) i •
Address: i ._,...i.A.)_.1(sAlci •
L - City/StalerLIP: ' rigt.---TOW4-°(---.9272- I•luor drain/floor sink/hub
. -..- ._ .
Carbage disposal
t---) ik < 1 N., I CANT
_..-•-•-• 0 CON PERSON ._ -
___ _. I maker
',•
\k) Rosiness name: . .13,,_714.61101.4L. b intereeptor/greas Imp 16.60
Con trtct name: 1,4)__it11) _ ._. _..
tvledicril gas I value: :iri , I . Page 2
- • - --
....\1 Address: r3 • D , , it, a .. _ pri,,c, - 10.60
__
.
.. ._ Roof drain tcotitmeeciall I 6.60
City/StalerZIP itL /
r •-• - - - Sink/hasin/lavatory '6.60 .
.'" Phone: 005 )74r).---7424, I'm: : critZLM _4 , ,,, , I 6.60
.. 'I'lloisnowcrishower pan . •
E-mail: urinal 16.00
-------
. .. -
-..- -. .
')01 CONTRACIOR Water closet 16.60
- •------ --
I f" Business name: _ 0 . - Water licater 16.60
-\ • ..
. ' ._.-
Other:
••\,s Address: . 0 i1/44 • ,‘ _____K , . . -..
subtnial 534-7..-C
• • . • 4 1 - Munition) permit rec: S72.50 , .
-- •
Phone :151.- 6, Vax: b)
ceB 2.41.7_,a3 Residential hack llow minimum riermit lee: li36.::'.5
_ .-_ __. _ _.. ._ ..__ . • •
pl,,,, (25% o f permit feel
.._.. .- _ _Slate surchar (g".4 of Permit N
Aut
Li 13,11 2 A PluMbing 1 M.: 211-0 1 : 13 ,_
Print n .. -
i,,,,,,i,(.7,1 signature: g a, 4 ji TOTAL 1 IF IMP
- • • - _ _ _ _ _ ....._ ,_ • • ,._. _,
[ame: C , es 1 Date. t..1). 14_1 This 1:airatit;itrolcatio'll esrni if 8 nut ohiainett 'Mimi
, • • NO days after it has been accepted as complete.
' inethodolo<4y set. by •Iri-Count■ IIiiildin Inclusir± Service Roar
i s.litiitctirterrmits\ PLNi-Pctit'il APP.,10L' I 44Q-4(! OT(10/07./COMAVEit■
CITY OF TIGARD
BUILDING DIVISION 1 ' PERMIT #: PLM200 010 78
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/9 /2005
Phone: (503) 639 -4171 ./ .iiv jP i� ip �lllt
Inspection Requests (24 Hrs.): (503) 639-4175 "L
INSPECTION WORKSHEET FOR DATE: 0/14/2006 TIME: 7 :01AM PAGE: 25
SITE ADDRESS: 12658 SW KAREN ST 16 CLASS OF WORK:
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUM LOT #: 016 TYPE OF USE:
PROJECT NAME: BELLWOOD TERRACE CONDOMINIUMS
DESCRIPTION: Install clothes washers in units 16 & 17.
OWNER: MOZINSKI, STEVEN P, PHONE #:
CONTRACTOR: R D PLUMBING INC PHONE #: 503 -297 -7422
Inspection Request Scheduled For: Date: 8/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 034903 -01 503- 481-0240 N
Corrections/Comments/Instructions:
e
Fi ' SS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Ins
ector: ��� p 611 c'ilj
Date: � I � 1 � Ph one #: (503) 7 18
l
b
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005 -00376
13125 SW Hall Blvd., Tigard, OR 97223 r DATE ISSUED: 8/9/2006
Phone: (503) 639 -4171 *ih o�H "l
Inspection Requests (24 Hrs.): (503) 639-4175 _.-44, 11.
INSPECTION WORKSHEET FOR DATE: 8/11/2006 ;.- TIME: 7 :06AM PAGE: 82
SITE ADDRESS: 12658 SW KAREN ST 16 CLASS OF WORK:
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUM LOT #: 016 TYPE OF USE:
PROJECT NAME: BELLWOOD TERRACE CONDOMINIUMS
DESCRIPTION: Install clothes washers in units 16 & 17.
OWNER: MOZINSKI, STEVEN P, PHONE #:
CONTRACTOR: R D PLUMBING INC PHONE #: 503 -297 -7422
Inspection Request Scheduled For: Date: 8/11/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 034772 -01 . 503-297 -7422 N
Corrections /Comments /Instructions:
A( A IIMl _41IL.e#
/
❑ PASS n PARTIAL APPROVAL fl CANCEL ❑ NO ACCESS
FQIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: /V ( ; p Date: b ii Phone #: (503) 718 -