Permit 4 CITY OFTIGARD
i��a y DEVELOPMENT SERVICES PLUMBING • PERMIT
Rnai l � l l PERM I T # • PLM97 -0 ^228
- 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 06/16/97
PARCEL: 2S1O9DD -90211
SITE ADDRESS...: 12665 SW PRINCE EDWARD CT #A
SUBDIVISION • ZONING:
BLOCK • LOT • JURISDICTION: KIN
CLASS OF WORK..:REP GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 FLOOR DRAINS 0 TRAPS : 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 0 URINALS : 0 GREASE TRAPS • 0
LAVATORIES • 0 OTHER FIXTURES • 0
TUB /SHOWERS...: 1 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Replacemnet of tub /shower.
Owner: FEES
FAEDER type amount by date recpt
12665 -A SW PRINCE EDWARD CT PRMT $ 25.00 DRA 06/16/97 97- 295984
KING CITY OR 97224 5PCT $ 1.25 DRA 06/16/97 97-295984
Phone #: 620 -5125
Contract or
RAYBORN'S PLUMBING INC
19990 SW CIPOLE RD
TUALATIN OR 97062
Phone #: 503 -692 -4139 $ 26.25 TOTAL
Reg #..: 000878
• REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the PLM /Underfloor
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top -out Insp
applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
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 952-0001-0880. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987. • i
Issued 13 - Permittee Signature: /, /A ,f) . - �
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit # PLA-1 -
Tigard, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
Nerve a S a New Single Family Residences Only
Adtr... ❑ 1 BATH HOUSE $140.00 ❑ 2 BATH HOUSE $195.00
Job / g( .5 _/9- ;„ P2wCt w D G-, ❑ 3 BATH HOUSE $225.00
Address an Fee includes all plumbing fixtures in the dwelling and the first 100 feet
K i t.)6 Grz-/ ( Ci a, 72- - V of water service, sanitary sewer and storm sewer. See fees below.
Name (d name of Business) FIXTURES QTY PRICE AMT
hies rue, d oe 6). D - S 126 Sink 9.00
Mining Address n �r / - Phone Lavatory 9.00
a b
Owner l6S ,5w 1 ce / quli2l 1 Tub or Tub /Shower Comb. 9.00
•
C seStete i4 Shower Only 9.00
, Y k (� Di d C7.7...)2-/ Water Closet 9.00
Nam. toe a of ) Dishwasher 9.00
Garbage Disposal 9.00
Occupant Mama Addrew Got e P,,,,,,
Washing Machine 9.00
Floor Drain 9.00
City/State Z30 Water Heater 9.00
Laundry Room Tray 9.00
N°°,° Urinal 9.00
Pt4
PiirJilid �{ .31AL. Other Fixtures (Specify) 9.00
Contractor
Malin Address v L i pi, 1 j Ti�,� /f k,(t) 9.0
p o. 6/ - g,',) r 9.00
City/State Z10 9.00
L4 A o t ) OIL y 7V'12 Sewer 1st 100' 30.00
State Registration No. Pay e'°. Tax No. Sewer ea. Addit. 100' 25.00
S283;34 Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
give reason below.) 11 Mobile Home Space 25.00
Back Flow Prevention
,1 -d - -. -/i->7 Device or Anti-Pollution Device 9.00
47
(owner gent) Sete Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition Q alteration X repair Q Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist. Plumbing ' 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of '
building or property
'(Except residential backflow
prevention devices) .
o
NOTICE 'Minimum Fee $25.00 SUBTOTA
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE / • a C
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL n //�
TOTAL 9V , 0
Special Conditions / 14 ,Sea.
Date issued by
7/27/99 Activities for Case #: PLM97 -00228
1:53:42 PM
Assigned Ho ld Updated
Activity Description Date 1 Date 2 Date 3 To Done By . Disp. Level By Updated. Notes
PLMA003 Application received 6/16/97 DRA RECD DRA 6/16/97 •
PLMA005 Create Permit 6/16/97 DRA PASS DRA 6/16/97
PLMA050 (F) Issue permit 6/16/97 DRA PASS • DRA 6/16/97
PLMA715 Rough -in !nip 6/19/97 6/17/97 RAB PASS JT 9/2/98 tub rough in only
PLMA799 Final Inspection 6/19/97 3/13/97 MS FAIL JT 9/2/98 no one home 9/2/98 found this
slip in file and entered
• - inspection. jeanne t.
PLMA799 Final Inspection 9/2/98 2/4/99 RB FAIL RB 2/5/99 Left notice on site.
PLMA799 Final Inspection 2/5/99 2/9/99 RB PASS RB 2/24/99 Case final.
PLMA800 Case Finaled 2/10/99 VLN 2/10/99
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Page 1 of 1
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1. CITY OF TIGARD BUILDING INSPECTION DIVISION
& rdvr
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
`� -
I QS Q_�� "eate Requested - AM PM / 3625 BUP BLD
Location l Z (o La c ri (1).ri---c-Q ce' uite MEC
Contact Person Ph 4 9 7— 0 Zz
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: �� sl i l y
SIT
Post & Beam l
Ext Sheath /Shear 11,E
Int Sheath /Shear l L
Framing _/ ���,v (14i
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm ��^' "" v �
Susp'd Ceiling
Roof
Misc:
Final
P RT FAIL
11MB eJA.sfe
eam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain D rains
ART 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
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA r � J tXt
Approach /Sidewalk D _` 5 In spector
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: / I - A. . P.M. MST:
Location: S -' �AuriCL el 1 _ i /_ I . BUP:
Tenant: p Suite: Bldg: MEC:
Contractor: r P_ 6 J _ Phone: 65 r � J 3 q PLM: g 7' c2 -
Owner: (J Phone: ELC: -
- 5/;--S ELR:
SIT:
BUILDING BLDG (con't) t LUMBING.) MECHANICAL ELECTRICAL SITE
Site Post/Beam PoWBeam 'ost/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab ' I Rough -hi Ceiling Water Line
Slab Framing Top Out , , Gas Line Rough-hi UG Sprinkler
Foundation Insulation Sewer 1 ' Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm 4 Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved roved Approved Approved Approved
Appr /Sdwlk Not Approved No Approved Not Approved Not Approved Not Approved
FINAL AL 7 FINAL FINAL FINAL
'Lich 6. ;I/ 6,,,L,Z7e
D Call for r- -' 1 spectio i D Re' 's...ion fee of $ required before next inspection D Unable to inspect
Inspector: le if, /111 _ 1 Date: ..• / / Page of