Permit CITY " OP TIGARD PLUMBING PERMIT
`wI j" DEVELOPMENT SERVICES PERMIT #: PLM2002 -00419
` III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/30/02
SITE ADDRESS: 12974 SW PRINCETON LN PARCEL: 2S104DA - 21900
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION:
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 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 backflow preventer.
FEES
Owner:
Description Date Amount
BROWNSTONE QUAIL HOLLOW LLC
12670 SW 68TH PKWY STE 200 [PLUMB] Permit Fee 10/30/02 $36.25
PORTLAND, OR 97223 [PLUMB] Permit Fee 10/30/02 $0.00
[TAX] 8% State Tax 10/30/02 $2.90
[TAX] 8% State Tax 10/30/02 $0.00
Phone 1: 503 -598 -7565
Total $39.15
Contractor:
CEDAR LANDSCAPE
14145 SW GALBREATH DRIVE
SHERWOOD, OR 97140
REQUIRED INSPECTIONS
Phone 1: 625 3700 RP /Backflow Preventer
Final Inspection
Reg #: MET 00001581
LIC 75535
PLM 5843 LANDSCAPE
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699.
Issued By: �l I •� _ .! L Permittee Signature: ag/ rlY`
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Sent by:CEDAR LANDSCAPE INC Oct -29 -02 09:24aM from 503 62586235035981960 Page 1i 1
•
A ~ Plumbing Permit Application
. Dacerteceiv - 1 -D - ed: f o 1 Pt mtit /
City of Tigard Dj� q
>' j! ; _�y Sewer permit no Building permit no.:
Address: 13125 SW Halt l lv �fi�' _ ; *
no.:
City of Tigard phone: (503) 639 -4171 , Project/appl. no.: Expire date:
Fax: (503) 598-1960 O s{ - o 'a Date issued: By$ ) l Receiptno.:
Land use approval: l• ! Case Pile no.: Payment type;
11 IT OF 1'1'I1, ;1IT
01 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
ONew construction 0 Addition /alteration/replacement 0 Food service 0 Other:
JOB SITE INFORiMA l ION t'F ti(•IIFDl1LI. (lot special Wort ation u.0 checklist)
rob address: 121 74/ S w P1':'") e C llp t L42 Description . W. Fee(ea.) Total
Bldg. no I Suite no New 1- and 2-family dwellings only:
Tax Map/tax lot/account no.: cmduties 1100 IL tor each utility connection)
SFR (1) bath
Lot: ys IBlock: I Subdivision: 4.#€' c k)//w 0 r 0 4 , SFR (2) bath
Project name: S1 (3) bath
City/county: T /w46. I ZIP: Each additional bath/kitchen
Description and of work on premises: j'+li;n Site utilities:
Nor-it F/004.) Catch basin/area drain '
Est. date of completion/inspection: /o -3 C . 0 z_ Drywells/leach lino/trench drain
F ood drain (no. tin. ft.)
Manufactured hoarse utilities
Business name: C.Gi) j C,4^ () .4ef �c Manholes
Address: /y/ V.5 $ ' 4 4 /bre Ai - DA _ Rain drain connector •
City:5 G164.4o d State: 04 ZIP: 17 D Sanitary sewer (no. lin. ft.)
Phone: 62 g- - 370o Fax: Cats' - swat E-mail: — Storm sewer (no. lin. ft.)
CCB no.: 5 S s'S I Plumb, bus. reg. no: Water service (no. tin. ft )
City/metro lic. no.: .....,--f- pl... � Fixture or items
Absorption valve
Contractor's representative signature: .. J sack flow $reverter I a7. 27. S
Print name: S £ d s C N. s S eA Date: fa • t / '4Z Backwater valve
Basins/lavatory
Name: 8/2.c 1 c C !1/;' s s-e n CeDR+ 64,7 ce •4pr Clo hcs washer
Address; /y /4r$ s ..� & 1 04 Du nking t r
City: S6ren..o.. -� State: oe ZIP: q 7!4/v Ej ecxors/snm
Drinking fou •
Ejp
Phone: qGT- Z 77 2 Fax: 6 ze S t. E -mail: Expansion tank
Fixture/sewer cap
Name (print): Floor drains/floor sinka/hub
Mailing address: iaarbage disposal
Hose bibb
City: I States I ZIP: Ice maker
Phone: I Fax: . E-mail: . 1 terce tor! e 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 I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's si re: Date: Su
Tubs/shower /shower pan
Name:
Urinal
Address: Water closet ,
Water heater
City: . I State: ...I ZIP: Other. • • "' ,
Phone: I Fax: I E-mail: Total
'Not all jutiadl0i = accept d:t ept ore cards, please call jorismetioe for room.in<Crmn'tlo Minimum fee $ 6. z5'
Pisa O Maitre . Notice: Thi permit application
expires if a permit is not obtained Plan review (at %) $ -
; • d lade 0046 - 0 6)3 w 180 days after it has been State surcharge (Mb) , $ 5. -2
accepted as convicts. TOTAL $q,
%i t • ..,: of . oa coedit card G �P
Cerattmdtt at ;, . pK I►mn / 5
a40 d6le (6/DO/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requeste // S AM PM BUP
Location / a 7 � Suite MEC
Contact Person Ph ( ) cl — ? PLM ` 0 t'
Contractor 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 , ■ryAr
AL,/
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final 40.41111
PASS PART FAIL /-
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan r �
Other: r
ina •
6P PART FAIL
ANICAL
• ost & 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 El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA •
Approach/Sidewalk Date / Y Inspector , Ext
Other:
Final 0 NOT REMOVE this inspection record from the job site.
PASS PART FAIL