Permit C ITY OF TIGARD PLUMBING PERMIT
d`l DEVELOPMENT SERVICES PERMIT #: PLM2004 -00323
` JI- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/12/2004
SITE ADDRESS: 11507 SW PACIFIC HY D PARCEL: 1S136AD -04000
W
SUBDIVISION: VILLA RIDGE ZONING: C -G
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Adding (1) new lay and (1) new water closet. Replacing (1) existing lay.
FEES
Owner:
Description Date Amount
SMITH, EDITA M
833 NW 170TH DR [PLUMB] Permit Fee 7/12/2004 $72.50
BEAVERTON, OR 97006 [TAX] 8% State Surchari 7/12/2004 $5.80
Total $78.30
Phone:
Contractor:
CASCADE PLUMBING CO.
2630 N HAYDEN ISLAND DR SP #3
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Phone : 503 - 544 - 7464 Rough -in Insp
Final Inspection
Reg #: LIC 120893
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 -0 e IV You may obtain copies of these rules or direct questions to OUNC by calling (503)
2 -6699.
I ued By: ' •, Permittee Signature: x
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
ECE1 V ED
Plumbing Permit Application t • . 7-C
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� oOf Of I IY 0Ur" l l�N r >�°'�" Pent* No- No- (t[ - -07 3
13125 SWHaDBlvd.,Tigord.OR 97223 V 00111:1 o ,,���,,, :
Phone: 903439471 )> 1 50339t.196o r3vl� . Dandily
i __ -) I Doc RsdyBy'. Jeri 1 62 see Paget a W
Inset Hour tan w.citi tine Sao- 6394175 LL.l --° S pp)emal lf a6on
Y 4O
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7ateroct: ,rwrr�.tr�rd.Ortas �� � .. •.. -
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r ; '�� A �' - �;.���.,> Z • - Fw ipaoeilslrorwt�w
p New co�aocoon ❑ Demolition
Deseritniall ) Qtr. I Ea. 1 Tom]
.,. Additioafakaationtreplaceosent ❑ Other- Near 1-2.4unily dwdBags (includes 100 ft. for cad) utility convection)
el � ?� '�, ` -7" SFR(1)bath 249.20
D l- and 2,thoo7y dhreIIfag
SFR (2) bath • 350.60
SFR D Accessary building ❑ Mu2d- tami�' (3) bath 399.60
Eadt additional bath/kitchen 45.00
❑ Master builder ❑ Ot cs Fat sprinkler (___ sq. !L) - Page. 2 Ste OfilideS
11=111M11 _ �1:ri - spa
tii�� ` osi h basin Gramm drain 16.60
\ \ ( \. J ( D weU. leach line. or each drain 16.60
Suit&"w4gf�t 110• = �` Peoje t°alnt^ • p J(,a (l .( (� Footing drain (no. linear tt: _� Page 2
lyaaufecoae d home utilities 110.60
Goss > ctlt&r�a® to job silt Manholes 16.60
Rain drain connector 16.60
. Sanitary sewer (non linear fl.: __) Paget - -
Slarm sewer (no. linear (t.: _) Page 2 .
Water aavice (no. lines ft.; _ J Page 2 _
Snbdivisioa Lot no.:
Fire Or item
Tax mapiparcell .: lx t Abwtpdoovalve 16.6
„i .1 h. -- gtis :_rmy� t a =_' •'+ ri 3 {, •`24 Has bow preaartsr Page t
•• `. ,', 0 - di '580. Backwater valve 16.60
Clothes washer 16.60
. Dishwasher 16.60
_ �g fountain 16.60
s.: • ,� -�- -�: _ :,. 1• ... ,ark - � ;
� =' -- .. -1..;... . ' „ . r_ ft ?sl?` - € o:F -'• . • .-.'•:::: - q. Elcmorsimmep 16.6
Name: Fon tar • 16.60
Address Fommesewer cap 16
PloordrainlBaur sioiohub 16.60
Moue: itlLQr Garbage disposal 16.60 _
Phome ) Fax ( ) Ga (6.60
-4.a. ? E i : .. . . a �:f i ;, : , j - , .� Hose bib
it E ```' � " " " • :.� ice wrier 16.60
O ]e ra �! • , • O M lnttaresptodtyeasc 16.60
Contact name: ca P t 'l_! r Mtdmal gas (vales S ) Page 2
3 Pittner 16.60
adyKSr 2i, 30 r 'AL _ Roof drain (commercial) 16.60
Gry/SmtelZlP r. `\ ('- d �` $mldbasinilavatcey 16.60
ff M... Face . (S'r _ r C 4...r2 i Tublshowvfshovacr pan 16.60
E -mail: - Urinal 16.60
RIGEMENW:1:,...,-:1:- % ii; :; _ 1� . ; - _ _ . •_ =q31.. WaIR intact ' 16.60
wawa b-- 16.60
. � •� Other
Ad�ca 2113) N c1.err� . pi-. �? j Subtotal
at- Amu:2M .41.,‘ .eg I. A • r • - t Minimum permit fee. $72.50
Phone:( . 1-1e.1 - '?V
- (.eq Fame.(95-.) a8q-� , q Residential bar,:0or
aminiawart permit fee: 536.25 n� -5
Plan review (2yx, of permit fcc)
cCa Lie: Plamhiag Lic. era.: ) a QS State s lmhorme (6% o(omtit fee) _SS()
()
+o TOrALPF. air #28: tttarizadsi -s / i. � L► �
Au
` 138te, i ci - 0 a Ws versa application expires Wit pertain is net obmirted %within
/. a _ 180 days sear it has been accepted ss complete.
'foe methodology sex try Tri -Coomy Building Waspy Service eoam
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2 d 66996B2E0G -00 2U gwnid apeOse0 dSb :bo 170 60 inc
CITY OF TIGARD 24 -Hour
BUILDING. ' Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
p BUP
Received Date Requested 7 o AM PM BUP
Location / f SCE 7 r Suite MEC
Contact Person _ Ph ( ) 5 -7 L t5 ( PLM 3 L 3
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access;
Ftg Drain ' ELR
Crawl Drain fi've-'1
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
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
,4000 PART FAIL
• ANICAL
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
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL