Permit CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2001 -00381
, . 1y DEVELOPMENT SERVICES DATE ISSUED: 08/14/2001
13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11097 SW SPRINGWOOD DR 1 PARCEL: 1S134A6 -03201
SUBDIVISION: SPRINGWOOD VILLAGE ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 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: Suite 2: Change out water heataer.
FEES
Owner:
Type By Date Amount Receipt
WILSON, MAUREEN O'SULLIVAN AND PRMT CTR 08/14/2001 $72.50 27200100000
ROBERT C 5PCT CTR 08/14/2001 $5.80 27200100000
BY PACIFIC REAL ESTATE MGMT GR
PORTLAND, OR 97201 Total $78.30
Phone 1:
Contractor:
STAN THE HOT WATER MAN
PO BOX 33157
PORTLAND, OR 97292 REQUIRED INSPECTIONS
Phone 1: 503 - 760 -2992 Final Inspection
Reg #: LIC 130755
PLM 26 -632PB
EXP!REP
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: �✓ � . : i2 - Permittee Signature: ALL
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
08/10/2001 13:08 7610159 STAN THE HOTWATER MM PAGE 01
Plumbing Permit Appli Lion
City Date received: / yip P ermi t no.:
- C ity of Tigard 7 ' /C l l�Yr' poi 10.0 ., L 1I Sewer permit no.: Building
Address: 13125 SW Hall Blvd. Tigard, Ji permit no.:
City ofTI and Phone: ($03) 639 - 4171 Project/appl. no.: Expire date:
Fax: (503) 598 - 1960 - Date issued; V
By: I Receipt no.:
Land use approval: Case file no.: Payment type:
0 1 & 2 family dwelling or accessory 2 /Commercial/industrial "(Multi- family 0 Tenant improvement
O Now construction 0 Addition/alteration/replacement Cl Food service O Other.
JOB ' 1 1 1 : 1i \I io 14.1 1 : 1 ) t suit l )I'IIC ((or. special information u.
1 v cltccklia)
Job address: nog . • ∎ n • Woo. say- . Deacrl • . • u Total
Bldg. no.: Suite no.: o°J-• ew 1- and 2• , , y dw - only:
Tax map/tax lot/account no.: 100 R. for each wilily comeedoq)
Lot: [Block: Subdivision: SFR (1) bath
SFR (2) bath
Project name: , r\. e o (1. - \ ._.' ' ; • {rte SFR (3) bath
City /cowl : , . . . •���' additional •ath/kitchen
Description and 1. on of work on premises: Siteudlldes:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach Ine/trench drain
1'L 1 ' 1 1 1 t 1 :\t: ('U\ l tt:�l "lOIt
Footin: drain(no.lin. ft.)
Business name: STAN THE HOTWATER MAN Manh drai n s ured Noma utilities
Man
Address: P.O. Box 33157 -
Rain draa in connector `
City: Portland [State: Or .4 ZIP :97292 Sanitary sewer (no. lin. ft.)
Phone: 760 -2992 Fax: 761 -0159 E -mail: Storm sewer (no. lin. ft.)
-- MB no.: 130755 Plumb. bus. reg. no: 26 -632PB ` ater service (no. lin. ft.)
City /metro lic, no.: 5670 Fixture or Item:
Contractofs represerttative signature: Absorption valve
Print name: Date: Back flowpieventer
Backwater valve
('(► \l.u'I 1•I:ItstrN Basins/lavatory
Name: KQ..IV l t o cr Clothes washer
Address: J 0 ishwasher
City: 'State: ZIP: Drinking fountain(s)
Phone: — I Fax: E-mail: E'ectora/sumQ
Ex • Ilion tank
()11 \I it Fixture/sewer cap
Name (print); r % n C e !' 781 r IS n en im Floor drains/floor sinks/hub
Mailing address: 7 8 3 I SE 141 -h<- • • J i. • a"l al0 Hose b bbisposal
d ry : K01t1 le..as.�\ t_ Stat ZIP: 9 . 7 2 0 '^ Ice m. er
Phone: 7? /1-(100 4 _Fax: I E -mail: Interceptodgrease 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)
Owners signature: Date: Sum .
I: \(:1 \1:1:11 Tubs/shower shower part
Name: . Urinal
Address:
ater heater
City; State: ZIP:
Phone: Fax: E-mail: Total — - •
• ny at ►e"m�a°° amt p call rit.e�� rQ t Minimum fee $ 7 a , eo
tfvla. 0 MaWCard G 2. K This permit application
tam. esd y88� �03. --V.'S • S /y expires if a permit is not obtained Plan review (at •_ 96) $ C e� c pl within 180 days after it has been State surcharge (896) $ m da d as w lee. s TOTAL $ 7
5
EXPIRED
4404616 (6C OCOM)
- CITY OF TIGARD BUILDING INSPECTION DIVISION -
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Z AM PM BLD
Location d Si
6vr, Lg Suite MEC
Contact Person -- 71 / 0-14 Ph PLM 0 — 00g(
Contractor ���,.." ����,� Ph 7 SWR
BUILDING Tenant/Giu" S 7q 7 /' G / 7 ELC
Retaining Wall ELR
Footing Access:
Foundation 4 FPS
Ftg Drain SC.(m2 2S• fQ4/ s 11 /its4&4%
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm O co C 4 co"
Susp'd Ceiling f �
Roof
Misc: crec�t'S .
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out ° p
Water Service _ !r C l / C
Sanitary Sewer
Rain Drains
Rn�
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
Low Voltage b EXPIRED
Low V f�
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
Approach /Sidewalk F- Z Z - / - 1�t; "// l f v
Other Date Inspector c?' 'C . Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.