Permit A er
CITY OF TIGARD PLUMBING PERMIT
P ERMIT #: PLM2002 -00495
� DEVELOPMENT SERVICES DATE ISSUED: 12/20/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15615 SW QUEEN VICTORIA PL PARCEL: 2S110CC -09100
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 004 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: 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: Install gas water heater.
FEES
Owner:
Description Date Amount
ZANE MULHAUSEN
15615 SW QUEEN VICTORIA PL [PLUMB] Permit Fee 12/20/02 $72.50
KING CITY, OR 97224 [TAX] 8% State Tax 12/20/02 $5.80
Total $78.30
Phone : 503 626 - 2939
Contractor:
F&F PLUMBING
6810 SE 45TH
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone : 503 260 - 0077
Final Inspection
Reg #: LIC 101473
PLM 26 -526PB
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: ,�,�+jl,L Q, � L � J Permittee Signature: I t')// Q /01
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business ay
12/19/2002 11:53 5036393771 CITY OF KING CITY PAGE 02/02
PlumbingP Allpp on )1' 11( I', i ;
Date main* , -Do- Permit so.. i ZDa. -06y4 •
�of Ti D D Sewer �::.. aa: A no.:
Addmax 13125 SW Hall B
Montt (503) 639.4171 PtolactompL aor: IME
1Ita: 5904960 DEC 19 2002`1 n EV ' a
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Land use approval: CITY Or TICARD /
Payment tip=
4:1 2 fam7y doodling or 000essoly O a btelti4amily O Tanana improvement
construed= O Additionfettarationikaplacemat Wood service O Other: -
.1(w -.I 11. I'•! r)IZ \) `. I iO\ I I -( Ili I)1 11 'In, •,iii : i,ii inInr„uliii,u u.; , i:c. :111•.1
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=, B11 mu S no.: � ew al l
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name: ^ Olt 0) 1 ba h -- - '
citylea nty: l:� 1 Zipt ct731t/ Pack nrkfitiond baddidtebm. •
Description , , , - • • , o ... , . An Slie
h AS" •• ' ' • W It Cmett besinfama dean
-
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Busks= name: F i+. b: Manholes
Addle= (01 I 0 e Rain dew c®eetor
'or-ft aA A A /� � )� (bbe: 041 ZIP= q7.1 Smeltery aawaa (a1m. ft)
Cal no.: (o 1Lr73 Plumb- cos. reg. igrj1. -sai.P8 water no. ' . ft)
Phaiteir flaw
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Print thIMM h er r ► f ' . Daps: �„• ,. valve - -
(r.I \i 1 i'l.lo,ON
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6 trfr . P h' Frart Ct1
Addre 1311 /(6 - bA!At - mss) -
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ml \1 i;
Ff7madteaer - .
Name Zu,� M.A,i h , ,
Bathe=: 1 4, / au T - - 4 9 , 10 , -, l • e Owed _ Hose Mb c l C 9g., zip: 6 / - i- - �o, - .
now �rYf - �R e) � IPont : IntemeporIptese top ._.
Gamer " " resintemace only. The Boton[ halation himaeo '
•
will be made by The or the mam1maoaeand rep& mode by my molar Roordnaft(commeaden
employee on the For W I awn as per ORS Chsptler447., Siek(d)rbaam(s).htva(s)
Ovinersiiiiimmzsmimamer_Dett: tun
Nam= 1
Addle= Wate rdoem _ .
Water / 1G.
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-
owes a Notes i 'a . Pleine piew (it_'1) S
�ifip���
ma mob= / / State I! ($%). -- $ _ C -1°
itopme 180 days saw 0 Wen Tor*" $ 'l 'S - 4)
*ME ormatekmmass karn m marl ewo 000eped as comma
- ; Armpit
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business tine: (503) 639 -4171 MST
BUP
Received Date Requested /e 2 3 AM PM BUP
Location /56 Is" a Suite QL '
4 1 MEC ° - 0�5 7
Contact Person U ' ' Ph ( ) 626,c) - 0077 PLM a- 9s
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain /\ m ( O ELR
Crawl Drain (�
Slab Inspection Notes: SIT
Post & Beam Anch
Ext Sr ea h /Srs 642Q /7 1 �� ,, pA n . �, t
Ext Sheath/Shear l/rl /7 � �
Int Sheath/Shear n
Framing
Insulation -
Drywall Nailing yi'Ar . AF � 4ior
Firewall
Fire Sprinkler
Fire Alarm P
Susp'd Ceiling r -
Roof
Other:
Final - J ! ,/% ■ltil ' d . .
PASS PART FAIL /
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: •
egr'
PASS er FAIL
MECH • CAL
Post & Beam Rough -In Gas Line eQ•41'.-
Smoke Dampers
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 11 ) a
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL