Permit CITY "I'FARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2004 -00073
' 111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/18/04
SITE ADDRESS: 09445 SW LOCUST ST PARCEL: 1S126DC-04900
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P
•
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: 1 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Water service repair on east side of building.
FEES
Owner:
Description Date Amount
BBH INVESTMENTS
9445 SW LOCUST [PLUMB] Permit Fee 2/18/04 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchari 2/18/04 $5.80
Total $78.30
Phone :
Contractor:
DETEMPLE CO INC
1951 NW OVERTON ST
' PORTLAND, OR 97209 REQUIRED INSPECTIONS
Phone : 503 Water Service Insp
Final Inspection
Reg #: MET 1986
LTC 2510
PLM 26 -25PB
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
Issued By: ACOS , _ Permittee Signature: e--A7
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
\
02/13/04 FRI 10:19 FAX a001
.2Pr ?"�.e, as t�i,?`a
Plumbing Permit � x�n ?r: ` �� v
e mat A I>lcati! n A.
•
PP . FOR OFFICE CASE ONLY
City of Tigard
Received
13125 SW !fall Blvd,, Tigard OR 97223 Datc /ay: 2 �3/d y Permit No,P oa y J
- XQ7 /1
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
24- Hour Inspection Line: 503.639.4175 iJ AL' Bate Dare fay: Other Permit No.:
Internet: ww�v.c i. tigatd_or.us 2^� -.. Date ReadylBy: Jam= b7 See Page 2 for
Noticed /Method: l � Su
-,
- - : / � pptemental Infiirnnation
0 New construction ❑ Demolition For special information use checklist
Description S tv. Ea. Total
El ent ❑ Other: for each utility nr t
ion)
-
ti on/al tera tion/rep lacem
,;, ., ,,;, _ - New 1 - family dwellings (includes 100 ft. f h t' r
_ ...... ..... .... .�At'1'E15'A Tit .C'�'>lQl%1 b
... ,...: ^ '_ Conunercial Y ,:: ,,'., ":'., FR I - • .. , ::,.. ,. . _ SFR 249.20
❑ I- and 2- family dwelling ® /industrial - SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑ Other:
;:':<: :... ..::..:......._,. _ ire c ( sq. ) Pagc
Bi:SITE:. [t (FOR1F' A:T' CON, AND ; CA ION `; • :, ' : ;_ • , . ;' . p 2
- r s . R.
lob site address: 9 Site utilities
445 SW Locust ST Catch basin or area drain
16.60
City/State /ZIP: J Drywall, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: ( Project name: Commercial Building Footing drain (no. linear ft_: ) Page 2
Cross street/directions to job site: Manufactured home utilities 110.00
-- Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (rro. linear ft.: ) P age 2
Storm sewer (no linear ft.: ) Page 2
Subdivision: Lot no.: Water service (no. linear ft.: Page 2
Tat map /parcel no.: Fixture or item
:DES
1
Absorption valve 16.60
1~ I • •,T rLIN:
.... .... , . .._ .... . ... ..... .. ......... ... , ....,. `. ':' � .., . , : • . Backflow preventer
Page 2
Water service repair on East side of buildin Backwater valve
16.60
Clothes washer 16.60
Dishwasher J 16.60
- .,° • , .... nk fimuntain
{ . PROP R JY Y ETI ° = " - " ' >,`' , .., w in 8 E6.60
! jectors /sump 16.60
Name: (J //1.457
Expansion tank 16,60
Address:
Fixture /sewer cap 16.60
•
City /State/ZIP: Floor drain/floor sinIc/hub 16.60
Phone: ( ) Fax: ( ) Garbage disposal 16.60
O =A ' PLICANT ;.r '` .. `?', C.O . ., , Hose bib
. :_ : ,; . �. .1?�'E'A�"P;' �PERSfJI?rt; :. ; , •
:' ,_,...,.., ....... 16.60
Business name: Ice maker 16.60
Interceptor /grease trap 16.60
Contact name:
Medical gas (Value: $ ) Page 2
Address: Primer
16.60
City /State /ZIP: Roof drain (commercial) 16.60
Phone: ( ) Fax:: ( ) Sink/basin/tavatury 16.60
E Tub/shower/shower pan 16.60
; :_
Urinal
Business name: De ... >:.._ ....: ::'.,.:,-;. >: :. :.. P.a ;.; I6.60
Temple Company, Inc. Water heater 16.60
Address: 1951 NW Overton Other
City/State /ZIP: Portland, OR 97209 Subtotal
Phone: (503) 227.2641 Fax: Minimum permit fee: $72.50 r/ x: (503) 274.7686 Residential backflow minimum permit fee: $36.25 7, '
CCB Lie.: 2510 unibing Lic, no.: 26 - 25 PB Plan review (25 % ofpemmii'fc )
Authorized signature l State surcharge (8% of'permit lee) s, go
TOTAL PERMIT FRF.,
?8r5o
i' Print name: Shalynn Garcia Date: 02.11.04 ''°l' is permit application expires if a permit is not obtained within
FEB 16 200k
CITY OF TIGARD
BUILDING DIVISION ,
CITY OF TIGARD
BUILDING n Line: (503) 639 -4175 ''''
INSPECTION DIVISION Business Line: (503) 639 -4171 /9
B P
Received 2_ i S [Tate Requested _ / PM BUP
Location 09z/ GI.vLC , Suite MEC
Contact Person Ph (`j 03) 2 2 7" 2�p 40 4
Contractor ,C1 . Ph ( ) SWR
BUILDING Tena FOwne ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final C)
PASS PART FAIL I i
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Fin.
ifigr PART FAIL
HANICAL •
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: Unable to inspect — no access
Fire Supply Line
ADA o
Approach/Sidewalk Date ' Inspector 1 3 7 7//1 Ext
Other:
Final DO NOT REMOVE this inspection record from the job site. •
PASS PART FAIL