Permit 1 � _ h^'
A CITY O F TIGARD PLUMBING PERMIT
.. DEVELOPMENT SERVICES PERMIT #: PLM2002 -00361
" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/11/02
SITE ADDRESS: 11777 SW QUEEN ELIZABETH ST PARCEL: 2S110CD -00113
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 2 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: Replace 2 water heaters.
FEES
Owner:
Type By Date Amount Receipt
KING CITY RESIDENTIAL PRMT BB 9/11/02 $72.50 KING CITY
CENTER, LTD 5PCT BB 9/11/02 $5.80 KING CITY
BY LARRY DRAPER
LAKE OSWEGO, OR 97035 Total $78.30
Phone 1:
Contractor:
MIKE PATTERSON PLUMBING
15028 S MITCHELL LANE
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone 1: 632 -7374 Final Inspection
Reg #: LIC 81746
PLM 3 -359PB
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: . _ � J� Permittee Signature: a� n
- Dal+/
Call (503) 639 -4175 by 7:00 . for an inspection needed the next business day
09/06/2002 12:31 5036393771 CITY OF KING CITY PAGE 02
-09/ 06/2002 08; 21 50363937' I �a • • LA' P.O...., •
' TRf -COUNTY OFI t(7: C'Sf.: r) \L\
smvlc�cl ant P1uinbing-Pe I 't Apply Lion
', 7a. \ Date received. Permit no. (o
t City of King C , c
\ \r : Sewer perm no.; Building perrnit no.:
.�� t. 13125 9 W Hall B lvd .
Clackamas
Tigard. OR 91223 QCp n �j ?002 ProjecUappl. no.: Expire date: •
Multnomah phone• (503) 639 , 4171. F : (s() 68I - 7297 - ,• y.
f �•�`i ' Date issued: B `Rece no.:
Washington g 1 u i u,::.• , , - , ., �
c o N r r 6 s Land use approval: I e {�('= ' file h
.r Case e no.: Payment type:
t,1 m
l‘ . PE OF PrRAIIf
❑ 1 & 2 family dwelling or accessory f Commerclaliindustrial Multi family CI Tenant improvement
❑ New construction - dditiort/alteration/replacement D Food service 0 Other:
.Jolt SITE INF OR.\i,6 rioN F l• : r Sr H F DULL (for , iprcial ittfi,rrnatinn u' checklist)
Job address: I l l 5 W Q✓« IgrnRrjMIIIIIIIIIII s •. „ t„ 1 Total
Bldg. no.: Sur no.: New 1- and 2-family dwellings only_
(taciadea loo ft. for each utility ceeaaaetioa)
Tax taap/tax tot/account no.: SFR (1) bath •
Lot: Block: Subdivisi. • SFR ( ) bath IIIII -
Pto'ect name: IIIIMIIIIIIIIIIIIIIII S -. (3) be /1111=11.111.
City /county: K,', C.; y ZIP: _ Each a• bathAtit:chent MINI
—
Doscrip' on and ltxano of wprk premise': Site utilities;
t (Er . ,g " Gib I . Catch basin/siren drain . •
• I
te t tiodi ` , a . ells/leachili nehreneb drain
Est date of co _
nspoction: j O o- . .
Donis • . n (no. c u .)
P L I I r H IN(.. C 11 �i l' it . Cl OR
Manufactwed home utilities NE MI
Busntess Dame: o. J ' anhoios
Address: 7. -_ ; Ni , (( IIIMAIIIMIIIIIM Rain • . connector M WM
Cory: 0 - C,••}» iZEI ' r • : 9.70V : i sewer (no. ltn. ft.) ME
Phone 5 ' 3 3 (o32 r l Storm sewer no. lin. ft.) 11111111.11111
CCH no.: E I yb p lumb, bus. r Water service (no. lin. )
City /metro lic, no.: >r i g. no: 3�3 s� 3 Fiattnra or itent: tm IIIIIIII
'. -- Abso 'don valve __
Cqucta's : mauve signature: � i / Bank flow . venter
Pions name: e • III Dane: 6[� Backwater valve —
�
C(E" T.\t.; t PERSON i asins/lavatory
Name: I Clothes washer
Address: I Dishwasher
II. ZIP: ' 1••I ng oturfain s) � ��
Cary: State: � iP: •eetars/sum •
Phone: Fax: a , 1111101111111111111=111111 Ex • : rtsion tank
OWNER Fixture/sewer ca . 11111111111111111
Name (, rint). I Floor dm its oor sink. MEIMMIIIIIIIIIII
Mailing address: : • age sposai
Hose bi bb IIIIIII
City: State: 11111 ZIP: ce maker
Phone: Fart: E3 nuiI . tierce .tor grease trap NM
Owner burralattonhwsidrnee! maintenance 0 k : The actual installation ' mer(s) II2
will be made by me or the mailttenancc and re made by my regular Roo • • 'n (commercial) ' r
employee on the property I own as per ORS w 1 ter 447. ink(s). bassn(s). le s EMI
Owner's • ore: Date: ILIMINEMIIIMININIMIONII '
-
FS ; /NEE t Tu. ower /shower pan r11111111111111111M1
\lame:
Address: eier closet
Water heater 111/11 . ,ta
:icy-. State: I� Other: �1/1.1.11.•
'hone: Fax: it Total IMO pm
Minimum cc
W fee
• e
rr aA jWtebi lleaa aaop4 eradh rafts. Ow can tYrbniGlpa IM C b(brmorion. Nader: Tkir permit application Plan review f as 0 MasterCard IJtpires if a imentit is nor obtained ( at _,,,,,, •e
) a S.
.,err. ea.d namtrw: / State surchar (8%)..... a
Ens h.., within /80 da after 1! has Baas ,
Name eToardi older u .eww o OR aeon �qry
wow as complete. TOTAL >,
Cxdttoidn Mansion Amami 4404616 (6ApPCOM I
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION -. r Business Line: (503) 639 -4171 MST
BUP
Received Date Req�ted • AM PM BUP
Location 1 !' _ / . - I: _ MEC
Contact Person P 1 ) 7371 PLM — w 30
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 14 _ ',Id '.,r ELC
Footing
Foundation ELC
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
Other:
Final
RT FAIL
tLUMBI
POST& beam
Under Slab
Rough -In
Water Service
Sanitary Sewer (a) Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan ,„ ] t,
Other: t/ V
,ME� 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 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 6
Approach/Sidewalk Date V/ nspector — Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL