Permit A - " CITY OF TIGARD PLUMBING PERMIT
i DEVELOPMENT SERVICES PERMIT #: PLM2002 -00199
� !I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/5/02
SITE ADDRESS: 11981 SW PACIFIC HWY PARCEL: 1S135DD -05000
SUBDIVISION: ZONING: C -G
BLOCK: LOT: 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: 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: Replacement of water heater.
FEES
Owner:
Type By Date Amount Receipt
DREW ADVANCED AUTOMOTIVE PRMT CTR 6/5/02 $72.50 27200200000
11981 SW PACIFIC HWY 5PCT CTR 6/5/02 $5.80 27200200000
TIGARD, OR 97223
Total $78.30
Phone 1: 503 - 635 -4786
Contractor:
COLUMBIA HEATING + COOLING INC
PO BOX 230397
8900 SW BURNHAM ST STE E -110 REQUIRED INSPECTIONS
TIGARD, OR 97281 -0397
Phone 1: 624 -2704 Rough -in Insp
Reg #: LIC 76359 Final Inspection
•
PLM 34 -175PB
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 -0080.
You - • • • -•- opies of these rules or direct questions to OUNC by callin• (503 1.:487.
4 -
I sued B I . l, ��( ,� ./ Permittee Signature:
Call (503) (503) 639 -4175 by 7:00 P.M. for an inspection needed the next -s "ay
JUN -04 -02 12:17 PM P.01
`a " � t .
•
• • , '
,' Plumbing Permit Application
�t -:. g Ply
0!,. : ; :? P of T>tgalr V
' #'i:: Adth�:ss: 1 zs SW Ha a���� t+� •
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., .Ery gard Phone: (503) 639 -4171 Project/appl. no.: ire date: ^ .
c Fax: (503) 598 -1960 JUN — 4 2002 Date issued:�J Receipt no.:
`.n '.(: • Land use approval: G r'g tl IF i lt.>fil Case the no.: Payment type:
' II PE 01 PERnii l
, r,. i °r., 1 & 2 family dwelling or accessory U Commercial/industrial 0 Multifamily ❑'Tenant improvement
''r
.Y4• • • New construction i�Adtliliun/altar�ttiutt/repla tnent U Food service U Other:
=
"'� '1:2 .:i,
1 T JUB SC1 E lNFU11i11A17UN hEG SCIIEUULE (for special information use checklist)
• Job4dress: j 9 2 / ..51.4 " e; ,•c_ f{% /IW 4 y Desert . lion [+l '1 oral
New J. and 2- family dwellings only:
II
,, Bldg, no.: Suite no.:
/ includes 1001 forcachutilil connection)
li • Tax tpap/tax lot/account no.: • T ( Y
SFR (1) bath
='� , �,1 ',r t Lot; Block: Subdivision: SFR (2) bath
I fj
• >><: Vru a l name: _ SFR (3) bath _ INNIS
C ci ! ounty• r -� _ rl ZtP ?7 223 Each additional bath/kitchen
" • ``? Description and I�cation of work on premises' Site utilities:
111
- s r ./. _ _. .4- r . :PP-5 Catch basili/area drain
; 1,� • : t . t) co �1c4onlinspc ction: �� Drywclls/Ieach line/trench drain MI
"leis ''Y Footing drain (no. lin. [L)
.';;? ; PI( iNIIllNG ('ONTRA(.'TOR
';;,,,., , Manufactured home utilities � ��
) • ' t • ' . Manholes
k t. r mom
, •Vi Rain drain connector
`j ! Sanitary sewer (uo. tin, ft.) ' '!, ; Storm sewer (no. lin. ft.) MEM
'''' + .. -'t no.: 1 Plumb. bus. reg. no: .y -17s 'b Water service (no. iin. . Mil ° 3 Fixture or item: •
6i o lie, no.: /27 - Absorption valve •
,, , ..0 . t. or's representative signature: �: +tom `% i_ Back flow r .venter _
,Ill, le ,! . ' �� aL ti a t0 Backwater valve
:',, :i ,,. CON i.�( I I''.:ItSON
,., I Clothes washer _
. :. Address: Dishwasher —i
"•�st' , Drinkin • faunlain(s)
.; r, ; , ►rs�'� State: Zn': E'ectors/sumL Mr� .
+''; `} St'.t!.':�a: - . ./ 4 )r -mail: Expansion Lan MEMO
, O11 NER —�
l, 1, Fixture /sewer cap = Moor drains/floor sinks/hub = . •
:/ aip (print): • t lG(,✓ MIE MEE
: address: ) Garb, _e dis' •sal
h: . 1 ;�� �'�'1��Li:� Hose hihb 11.1111111=1111M111 -, 7 . r _. Statc: of ZIP: ? .22
ice maker
. • , i i . e: fr. S- y7. •• Fax: E-mail: lnlerce.torlgrease trap
F bympr installation/residential maintenance only: The actual installation Primer(s) MINIM
wi be made by me or the maintenance and repair made by my regular Roof drain (commercial) I MN .
.
iempfoyee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) _ .
't il a' $ _ - . : Date: Su (
Sump _- . ENGINEER Tubs/shower/shower Lan
,r- , Unnal .
=,, •, ;, ate- closet r :
... Water heater
Slate: ZIP: '
;1�. � Other: �� ®'� ,
«'' E -mail Total r
`{ ';: , • �ce�t t catc please earl J�rtsdsc fx awrc tnratootioo Notice: -Trig p ermit application 1Mi nimum fee $ • . .
r; i
.:,,,. Plan rcvicw ( at _ % $ •
t , 9 a M "`r°' c �"° expires if a pr rtnil is not obtained
� / / State surcharge (x) $ _
. 15 within 180 days after it has been
' i' , i ; . �`�" accepted as complete. T OTAL $ -
t ' - showa on cre car
?:.i;! 't ismissimmtn=la ... , Amount x.4616 (6.00K M)
.r.`ii%J .
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION fpIVISION Business Line: . ( ( 503'639 -4171 MST
BUP
Received Date Re uested _ to AM PM BOOP6'fl - ON '
Location / 1 �j fi l _ Suite MEC o2 — c)d /S
Contact Person A/ Ph ( ) 6 ca ii— . - 9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: D ELR
Crawl Drain
Slab Inspection Notes: /2- _ SIT
Post & Beam 9
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing aid6----eic Firewall /„ [ p /� Fire Sprinkler f / w
Fire Alarm
•
Susp'd Ceiling '
Roof / if // 1 � �l7 /AO/
Other: . —
Final - -
PASS PART FAIL
PLUMBING I ,
Post & Beam 2 / �� - // -/_, /�
Under Slab -
Rough -In '
Water Service ,/ #/ ! 'l / i - f- i /I
Sanitary Sewer / I /
Rain Drains ./..AR M
111
Catch Basin / Manhole /
Storm Drain f j
Shower Pan - i . /� - '�� � / / - AO,/ " r 7
'ASS PART FAIL
MECHANICAL
Post & Beam
f/ _/'
Rough -In
Gas Smoke 0 t
Smoke Dam s
4ILM
PART FAIL ' �/
CTRICAL , i / • I
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 /99 Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL