Permit C ITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2004 -00361
t -� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/6/2004
SITE ADDRESS: 12115 SW LINCOLN AVE PARCEL: 2S102AB -00501
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R -4.5
BLOCK: LOT: 063 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: 1 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
Remarks: Install gas water heater.
FEES
Owner:
Description Date Amount
CAROL D. SCOGIN
12115 SW LINCOLN [PLUMB] Permit Fee 8/6/2004 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchari 8/6/2004 $5.80
Total $78.30
Phone : 503 888 - 4510
Contractor:
F & F PLUMBING & HEATING INC
6810 SE 85TH AVE
PORTLAND, OR 97206 -7787 REQUIRED INSPECTIONS
Phone : 503 - 774 - 5140 Rough -in Insp
Final Inspection
Reg #: LIC 101473
PLM 26 -526PB
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: L :77 � Permittee Signature: �qp
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Aug 004 11:21RM Heat Relief 503-261-S814 p.1
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST
BUP
Received Date Requested g _ ��- AM PM BUP
Location f I d..can.Z Suite MEC
Contact Person Z/Li Ph ( ) r2/ v — w 77 PLM ADD ( - 0O 36
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
. 141
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
in
ASS PART FAIL
M CHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl 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 IC j4 Ext
Approach/Sidewalk Date i Inspector
Other:
Final i i NOT REMOVE this inspection record fr m the job si e.
PASS PART FAIL