Permit C ITY OF TIGARD PLUMBING PERMIT
4 DEVELOPMENT SERVICES PERMIT #: PLM2003 -00589
`'` Ai' DATE ISSUED: 11/24/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06650 SW REDWOOD LN 220 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:,
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing tenant improvement, breakroom on 2nd floor. Other fixture is a primer.
FEES
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI [PLUMB] Permit Fee 11/24/03 $72.50
PORTLAND, OR 97224 [TAX] 8% State Surcharl 11/24/03 $5.80
Total $78.30
Phone :
Contractor:
POWER PLUMBING CO
P BOX 19418
PORTLAND, OR 97280 REQUIRED INSPECTIONS
Rough -in Insp
Phone : 503 244 - 1900 Top -out Insp
Reg #: LIC 52378 Final Inspection
PLM 34 -150PB
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
ued By: : Permittee Signature:,Ve(I / /
Call (503 • • • -4175 by 7:00 P.M. for an inspection needed the nex usiness day
Nov 11 2003 3:01PM HP LRSERJET 3200 p.2
`,'
' gl ues ' 3�. �:
. Plum Permit Ap Application •
! �!i! • Datereeeived: HEM.' 1
ti _ City , of ligard •.'tom.: Y • ��
Address 13125 SW Ii) 3 • Sewerpermit•no.: Buildingpernritno ? g
ChyOf/tigard • Phone: (503) 639 -4171 s • Project/appl.no.: - • Expire date:
Fax (503) 598 = 1960 1 2 2003 • Date issued:
' • NOV. By: lteceipttio : ? • .
• 'Land use approval: ' - _ Case file no.: • Payment type
. D
:. ❑ 1 &, 2•family dwelling or accessory • ommercialltndusttial , . :O Multi- family T er im
'
0 New construction • - 0 Addition /alteration/replacement O Food service • . . ❑ Other: pmvement
.1011 SITE INFORMATION FEE SCilE1)11LE (fur special inforu ation use checklist)
• Job address: 6 4 So. t c i . . Pe:r16,2o k.. Lam • Description
Qty. Fee(ea) Total
Bldg. no.: 64 5o I Suite no.: - 0 .,0 • New I- and 2- family dwellings only:
Tax map/tax lot/account no.: (Includes 100 8. for each utility connection) .
SFR (1) bath.
Lot: •
(11.- IBlock: • I Subdivision: SFR (2) bath
roename: C. 5 f S S + Gm 5
� SFR (3) bath
\ City /county: (.b t- #la.wl a, >Z 1 ZIP: q -7.2.,;.1.1 • sack hon �uhlYitcen
0 Description and location of work on premises: ,2 nek • 1=1 eve r . Sitenti6ties: " _
1 3 reAK .r a orr. • • • • • Catch basin /area drain • • - • \
Est. date of completion/inspection: — Drywelislleach line/trench drain . N
I'1.!)liltlil`G C'Oi1' I It:1[ "1 Olt Footing drain (no. lin. ft.) •
Business name:.. Pa " e P I,,,,r,.t„ .blr,c Manholes
• d home uttilities
Address:. Po. • a a X l . ci di is sin drain connector •
City: Po r-.}• - k ' I S tate: o R I Z�: 9 .. g5 O Sanitary sewer (no. lin. ft) •
Phone: a ci . m, l ci oo.. -'I Fax: aa./4. email: • . Storm sewer (no. lin. ft.) "
CCB no.:...5- .. $ • . I Plumb. bus. reg. no: 5 -15 o p g . Water service (no. tin. ft.)
City/unetro lic. no.: I e 62. •• • • - Fixture or item:
Contractor's representative signature: -- • Absorption valve -
Punt name: !'tLr1 Date: Back flow preventer •
r / " / / C Backwater valve
Basins/lavatory
• Namax ikG Lt�ar •ran Clothes washer
Address: �. O • o x 1 q Y145 • 7 .
City: fort Ia.�o I State: pQ ZIP a Drinking foanrain(s) " •
I cR724S
Phone: 240./..•/q ao . Fax V y 5/'$`671 E -mail: Expansion tank • "
M mitre/sewer ca
Name (print): Floor.drains/floor sinks/hub / . o
Mailing address: Garbage disposal
city State: I ZIP: Ice bibb
Ice maker
Phone: I Fax: I E-mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made b �
P • Y nt Y regular Roof drain (commercial) •
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: / /�. /O�
Date: Sump •
ENGINEER Tubs/shower/shower pan
Name: Urinal
Address: Water closet
Water heater
City: I State: I ZIP: • Other: - /67.40
Phone: I Fax: I E-mail: Total • ', '
Noe an J O Om ° ' ` • 1 call Jurisdiction for awn ioromfm® Notice: This permit application Minimum fee ,
CI Visa O MactaCard $ 7� 50
yes ifa Plan review (at %) $
Credit card member: -1—/--- permit is not State Burch 8% rbD •
ftp within 180 days after it has been ( ) ••• • $ • 5•
Name ur cardholder s thaws m credit card
accepted as complete. TOTAL $ 7 `n . 3 a
S /
Amount ,Q p.l /�� L c�m,otdat a ��, / �(,L 5 �._'". t , (.Ctr (�• r �� u 3 - +40 c2a0e.'oarq
•
Nov 11 2003 3:02PM HP LASERJET 3200 p.4
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
A eo BUP
Received 1 (CP 3 2 -5 D e
at Requested / 2 - / ( / PM BUP
Location - C� / ' (,�L� MEC
Contact Person _:7. Ph j U Z4/(— (q0 Cri 3 "-70
Contractor L Ph vim) t 3 — (o v Z9 SWR
BUILDING Tenant/Owner C F ( ELC
Footing UU
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
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Ot e:
Fin
f ar PART FAIL
Y CHANICAL
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
•