Permit CIT OF TIGARD PLUMBING PERMIT
ri DEVELOPMENT SERVICES PERMIT #: PLM2001 -00395
'�I I� 13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/22/01
SITE ADDRESS: 09982 SW WALNUT ST 021 PARCEL: 2S102BD -02201
SUBDIVISION: NO. TIGARDVILLE ADDITION ZONING: R -12
BLOCK: LOT: 039 JURISDICTION: TIG
CLASS OF WORK: OTR 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: Water heater installation.
FEES
Owner:
Type By Date Amount Receipt
HEKIMIAN INC ET AL PRMT CTR 8/22/01 $72.50 27200100000
BY ROBERT RANDALL PRES SPOT CTR 8/22/01 $5.80 27200100000
RANDALL CONSTRUCTION CO INC
PORTLAND, OR 97219 Total $78.30
Phone 1:
Contractor:
STAN THE HOT WATER MAN
PO BOX 33157
PORTLAND, OR 97292 REQUIRED INSPECTIONS
Phone 1: 503 - 760 -2992 Top -out Insp
Final Inspection
Reg #: LIC 130755
PLM 26 -632PB
•
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 m. • • - . •pies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Iss :d By: ' r ! j! � , , . Permittee Signature: Di1D, p "I /4
Call (503) • 9-4175 by 7:00 P.M. for an inspection needed the next business day
08/20/2001 08:53 7610159 STAN THE HOTWATER MM PAGE 01
Plumbing Permit Application
• Date received: P o /
• � . �'i_ City a Tigard $ Permit no.: GIGO a' 3Y5--- Address: 13125 ZS SW Hall Blvd, Tigard, OR 97223 Scwer permit no.: Building permit no.:
City ft/Tigard
Phone: (503) 639 -4171 Project/appl. no.: Expire :
Fax: (503) 598 -1960
1- N S / • /� a Q ll e S l e-/ A.) e.- t, 3�— S// 7, - 1 — Date issued: BY Re no,:
use approval: Case file no.: Payment type:
•
Q I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi-family
0 New construction 0 Addition/alteration/replacement 0 Food service 0 Ot ant improvement
JOB SI I l: INi olt 11110N 1. 1:1 :.•(711:1)1'1,1: (lor special inl''rn u.i• cliechli,t)
Job address: ) eAl,), S -ce...) Ce}/y.L Ai 4e. 7 S T - Deserlpdoq
New 1- and Tamil dw'• Fet:(ea.) Total
Bldg. no.:
Suite no.: #!•�i y ellipge only:
Tax map/tax lot/account no.: (Includes 100 R. for each laity connection)
List: Block Subdivision: SFR (I) balk
Project name: SFR (3) bath .
A A. e-'T U j (..1 • &-'e- • P T S . SFR (3) barb s
City /county: 4v1: , • 2ip: . Each additional bath/kitchen ME
Deacu 'on and of rk on pre et � _ Slteutilities.
G(�U Catch basin/area drain
Esc date of completion/inspection: ,' - -O Drywclls/leach line/ttench drain r
1'1.1'iNiBING t'ON'' I it:“Cftilt
Footin drain (no. lit. ft.) -
Business name: STAN THE HOTWATER MAN Manholes
home utilities
Address: P.O. Box 33157 Manholes
City: Portland sin drain connector .
St ate: 0r 1 Z1P:97292 Sanitary sewer (no. lin. ft.) .
Phone: 760 -2992 J Fax: 761-01591E-mail: Storm sewer (no, lin. ft.)
CCB no.: 130755 1Plumb. bus. reg. no: 26 -632PB Water service (no. lin. ft.)
II
City /metro lk. no.: 5670 Fixture or Item:
Contractor's representative signature: i /F� ` / / 7 I � Abso • 'on valve
Print name: h z„, /Age Q e, �� Back ow preventer IM
( t► \7:11 °1 I'I IitiON Backwater valve MI
Basins/lavatory
Name: / &/Z ~' Dig Ur 0 - ea 3q .. gJ 7 Clothes waaher
Address: Dishwasher
City: !State: 1 ZIP B fountain(s) -
Phone: Fax: E-mail: Ejectors/sump
Ex • : aion tank
c►1tNlat
ix sewer c. • _
Name (print): Floor drains/floor sinks/hub
Mailing address: Garbage disposal
City: State: I2IP Hose bibb
Ice maker
Phone: Fa:: E -mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primers)
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: Sump
1,Nr,I Tubs/shower/shower pan II
Name:
Urinal
Address: W IIII
City: J Stara — ZIP � — —..`te heater
Phone: F ax: E -mail:
Total
'�OO' credit cads, t eau i>m far mope iafamylao Notice: This It application Minimum fee $
Vw 0M -- ..., G , 414 a iresifa ono t obtained
Plan review (at $ • permit is no )
t�Cdli erd m ,. >i - �
// :�a►� within 180 days after It has been State surcharge (89b) .... $
N d ` � cm edit cad accepted as complete. TOTAL $
.t AMMM
4W406 t6A1MONO
- CITY OF TIGARD BUILDING INSPECTION DIVISION MST •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ) - n - � '� AM PM BLD
Location �� 1f F c Gd��l i > Suite MEC
Contact Person 1 ' /Pr, Ph („ : 9 - &aS PLM
Contractor Ph SWR
BUILDING Tenant/Owner 6t2t- r ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab //j. • SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
I
Susp'd Ceiling r(/'� --e n a- S S 7 1 .4 l Q
Roof
Misc: p e_ L Ad-pi Final '7 f�
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out � , f,
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
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
ApproachiSidewalk Sr 7 /6 I 1, l / /
Ext
Ex
Other Date Inspect
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
G� c� BUP
Date Rested / — I I AM PM BLD
Location 5; Suite MEC
i
Contact Person ft • Ph - ; c 1 7 PLM ,a66 ( - l U�
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab art / / '/ SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation � lv �cc-e� s O R ? Drywall Nailing � ""
Firewall
Fire Sprinkler v-e �
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
• PASS PART FAIL
1(
PLUMBING /
Post & Beam
Under Slab
Top Out ��/ 3
l
Water Service
Sanitary Sewer
Rain Drains
P ASS PART
MECHANICALL.
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
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 o f 1 /
Other Date 9 "' / S — a/ Inspector a1� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.