Permit CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM2002 -00099
fi
DEVELOPMENT H Hall Tigard, SERVICES 639 -4171 DATE ISSUED: 3/22/02
SITE ADDRESS: 13066 SW PACIFIC HWY PARCEL: 2S102CB -02600
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G
BLOCK: LOT: 020 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 3
OCCUPANCY GRP: M 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: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install 3 back flow preventers.
FEES
Owner:
Type By Date Amount Receipt
CAPONE, ANTHONY M PRMT CTR 3/22/02 $139.20 27200200000
13056 SW PACIFIC HWY 5PCT CTR 3/22/02 $11.14 27200200000
TIGARD, OR 97223
Total $150.34
Phone 1:
Contractor:
METRO ROOTER + PLUMBING
BARRICH INC
5008 SE WOODWARD ST #3 REQUIRED INSPECTIONS
PORTLAND, OR 97206
Phone 1: 652 -2626 RP /Backflow Preventer
Reg #: LIC 106824 Final Inspection
PLM 3 -265PB
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 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: ai"
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the n t business day
•
03/19/2002 13:44 5032416565 MRP PAGE 01
.,. ' . Plumbing Per
O� � g R)<� Datereceived: ✓, 1 Perm X itno. :Y v.)0trA -- r %' J.9 • ; • City x ' , 1 - .1l� permit oo.: Building permit no.:
Address: 13125 SW Hall Blvd, Ti_ ,..
City of Tigard Phone: (503) 639 -4171 ECE IV
I ii-
, '] appl. no.: Expire date:
• Fax: (503) 598 -1960 Date issued: cm Receipt no.:
Laud use approval: MAR 1 9 200? Case file no.: Payment type:
0 1 & 2 family dwelling or accessory SRCommercialTtadustrial ` • O Multi- family 0 Tenant improveniei : r::, •
' 0 New construction -- ' `...:. -
..-.. -0 Addition/altezationh eplacemeut O . Food:seiv'ice;wf .a,Orhe . _ — _ <:
.101151T1.• :INIORN1ATION ri:i :SettE1)l:l_1 : (for special inforliatiu ) use checkli.st) ' ° '
Job address: /3664 451 %I ' Description . Qty. Fee(ea.) Total '
()
New 1- and 2- family dwellings only:
Bldg. no.: S ' no.: (mdades 100 ft. for each utilitycnnnectlon)
Tax map/tax lot/account no.: SFR (1) bath
Lot: Block: I Subdivision: SFR (2) bath .
Project name: i_ i i ,Qi I /. L!%l1e, SFR (3) bath
I ' ' /
City /county: 1 ZIP: J .. Each additional bath/kitchen ,
Des ' . don and 1. •/ :on o work on .remises: Site utiliti=
♦ / i - Catch basin/area drain —
Est_ date of completion/inspection: _ _ _ „9 E2 02.
Drywells/leach line/trench drain
PL l;141 R 1 N G CONTRACTOR
Footing drain (no. hit. ft.)
Manufactured home utilities
Business name: Le ' 1/I /0. a . ' ...,/ .! J ! Manholes
Address: /,/ y i> ,y Rain drain connector
City: ! Orffji I7/1 Stateee I ZIP1'7� -9.Z/ Sanitary sewer (no. lin. ft.)
Phone / ' p I FaJO 4.610 -mail: Storm sewer (no. lin. ft.)
Plumb. bus. reg. no: 1,Zrp,•5■14/9 Water service (no. IEn. ft:)
City /metro lic. no.: 400 4=32/60 Fixture or item:
Absorption valve
Contractor's representative signature: / , - i V 4.. �,f Back flow preventer . , - I / 02-D
Print name: _ i i/ 7 7j D . j' 4 ' Backwater valve - '
CONTACT PERSON Basins/lavatory
Name: Clothes washer
- Dishwasher _
Address: Drinking fountains)
City: I State: . I ZIP: Ejectors/sump
phone: Fax: E-mail: Expansion tank .
OWNER Fixture/sewer cap
Name (print): c •i, / / /. r _ .- i Floor drains/floor sinlcs/hub
Garbage disposal •
Mailing address:
Hose bibb
City: • ge - eg42 ]State: ZIP: Ice maker
Phone: I E-mail: at trap
Owner installation /residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular . Roof drain (commercial)
employee on the property Town as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: _ Date: _ Sump
ENGINEER Tubs/shower /shower pan
Name: Urinal
ame:
Water closet
Address: Water heater
• City: • . J State: ZIP: Other
Phone: Fax: E -mail: Total
•
Not ail iu Midi.= accept credit cards. please dl isaitdicdoo for mom infonnattion. Mini fee $ !• . 9 A •
Noti e: This permit application
XVrsa ❑ MastcsC r. Pl an review (at _ %) $
exp tf a permit is not obtaiaed h State surcharge 8%
•
Credit card o days ( ) .... $ f lt1
w i thin 180 after it has been
- F>iClet.c4r — J Q'it E. TOTAL $ / .rep . 3 q
tiler w on d rat ard s /
c C 0 3 accepted as cotnplctc .
Czdholder crgnature
Amount , 440-1616 (6/00.COM)
■
WFTIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171
MST 1
BUP
Received Date Reques d _ 4-4 AM PM BUP
Location /306, Suite MEC
Contact Person ( Ph ( ) 6 PLM
Contractor n / � 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
f.
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, p
Other:
Ir -i
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 / I
ADA l am - / 2 ' r L�� .
Approach/Sidewalk Date / Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
41111WOF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received / /_ Date Requested 1 1 — I ( AM PM BUP
/
Location 3 ` J Suite MEC
Contact Person Ph ( ) PLM a08 ` 0 ' 0 6 17
Contractor Ph ( ) Sa - SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access: Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear /2:fi0 p Fr aming ���� �✓ Drywall Nailing E`er` / / 77/a f
Firewall
Fire Sprinkler =
Fire Alarm _M��
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 C) _ f
%
Other: (�5
� _ =J PART <I, R _«�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 W///,2 Inspector r YZQ - 'e • Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL