Permit CITY OF TIGARD
PLUMBING PERMIT
*I4. DEVELOPMENT SERVICES PERMIT #: PLM2004 -00480
..� II 13125 SW Hall Blvd., Tigard, OR 9 (503) 639 -4171 DATE ISSUED: 10/22/2004
SITE ADDRESS: 11507 SW PACIFIC HY A PARCEL: 1S136AD-04000
W
SUBDIVISION: VILLA RIDGE ZONING: C -G
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 2 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace (1) existing 2" floor drain, (2) new foot wash units, replace (2) foot wash units.
FEES
Owner:
Description Date Amount
SMITH, EDITA M
833 NW 170TH DR [PLUMB] Permit Fee 10/21/2004 $83.00
BEAVERTON, OR 97006 [TAX] 8% State Surchari 10/21/2004 $6.64
Total $89.64
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 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)
246 -6699.
Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
RECEIVE
Plnmbine Permit Application io ns 2404 FOR c, F F 1 c r. 1 r r•.
City of Tigard CITY OF TKiA 1D / - / .W. lira.: ► ).■.,_ 0 -,o , •
13125 SW Hall mod. Tigard, OR 97223
shoat 503.6 9.41.71 FR S03.59e -1960 , UILCJIIv� biv . 0► - o,nerveneit*>e.: AL-..2G0/ GO X0
DeeiBr 24- How �
-ion Line 503.639A175 � i,L • -•! i L Dare lleadtr►Br r�.ee ® se= ter roe
rat faap www.d.tigasd,ar.us _ =- n GI ................... •
- .-��. �1?� - • :lj• . - r.��w" iZ.. .--..ti + �• ::�•_ iM•.M:4: 't *.' iC' { �+1 .•.. .i. .. Ci.: =:. .1..1..
0 New construction 0 D anditi m For specie b rformdaR we dhdlbr.
Description 1 Qty- I Fa I Total
❑ Other. Net 1- 2•amt'gr dndllaga (includes 100 R for tacit trolly wnnccdon)
Wn 11 - - - 7 7?4 • .. -, . r . r ' - spa (t)b� •
249.20
❑ 1 - and 2b i. Goannerciabiodustrial SFRa)lath 350.00
o Accessary bonding ■ Muhl - 1y SFR(3) bath 399.00
Each additional ba h/lotehen 45.00
p Master bnIIder ❑ Men a s : i n L__ sq. a.) 2
+1a dy1 �� •.ti [ ; . =� 't 3 Ste al Uhc
11 It ` - Carob h basis warm drain 16.60
--G; (, a r 4 Myna, les& lane. as watch dram 16.60
Fooling dr ain (no. linear tt.: __J Page 2
Statelbld�Japtaa ' Project yam= �a ■ : ti . I 1. 0.00 • .
M � hone amlfeahone utilities
tsoss to jab sift Manholes 16.60
- Eqpt drain connector 16.60
Sanitary sewer (no. linear 11.: _J Pagel .
Swan sewer (no. linear ft: ._3 Page 2
Subdivision: J Lot no.: water service (an. liner 0.: .__) Page 2
Fixture or item
Kt Tao P a no. _Absorption valve 16.60
Page 2
• • . ' ■ A. \ \ \ S� Backwater valve 16.60
1 Clothes washer 16.60
Dishwasher 16.60
T ` tbuntaia 16.60
- - ..... .. art 1:+•• \60 t... ` f i i�r�'� ;a - - - -.. e. O. ccwr3 m..� 16.60 •
Nacre+ Expansion trtnk •
16.60
Addr • Fawrelsewer ap 16.60
GttJSa1WZEP• Floor drain/Boorsmidhub t 16.60 At • CO ()
- Garbage disposal t6.60
i-g j.3F .. 17- . -41 - F -( �- )
. . '•,�' , 0 ' :- 1660 /ce maker
> a : Q rE P 1u m1� C 'n . . " faoctcapteT/lga�se emir 16.60
eoma.amt e, 1:0? I ('.,1 � 1 Medical gas (vat= s ) Page 2
Adder- 219 • : ex. - - �' - ' It- Primer 16.60
Roof dtsln (aommcld$l) 16.60
Gry /Srarel� d /� r _ / � � � vakny 16.60
Pbl� (�??j) _ Fait : (S03) . ^ ( Vl[tC� I Tublsbove 16.60
a' Urinal 16.60
: F �:t ) �j 1 : =t 22 • -.� .,•- �. t �=5: i•:' l? '; - � � � � << Wares closet 16.60
>~ ' �•
`
Vizier bearer 16.60
4 It . 0-x-3 oaten Fad 4/44 ‘ 0.'1 i/ _ �.. (sCp . L/ ()
Subtotal
City/StateiZIP: • r . 4 . - . ► Minimum permit Tee: $72.30 (} 0
> ( ) u - n Li (Q �(Si c Sq Clrr0Ciq Residential nmt
inapertaitfee:97625 °3 .
Plan review (23% of permit fee)
(:($ Lie _` , C PlomDirts Lie. sacra: - -- • - ' Stare surcharge (li% of permit fee) (a 4'; .
Authorized sib - TOTALPERMi1 FEE eq IP 1
y ` _ is net obtained ee{thln
Doc i i Aiwa p app moires ifs persai!
Plat coma - - - Doc /} 100 days after it has been accepted as a nuptete.
( b • i �tj 2s -(o (G ci q -Fee methodology set by 7si my Building Industry Service Bone.
Igo 4m-on ittowaleonvwae)
I'd 6699682E0S '00 2utgwnid apeose0 ezS :S0 'O ST 400
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested // 9 AM PM BUP
Location _10 / f _ _ Suite A MEC
Contact Person Ph ( ) . S itC — 7''5 7 PLM 7» q-00 4/ (it
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
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:
.4111 �' ��
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:
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 0 Please call for rei spection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / Inspector 97
Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL