Permit CITY OF TIGARD
PLUMBING PERMIT
Mi., � DEVELOPMENT SERVICES PERMIT P /12/01 -00650
^-` � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/12/01
SITE ADDRESS: 10030 SW WALNUT ST 009 PARCEL: 2S102BD -02300
SUBDIVISION: NO. TIGARDVILLE ADDITION ZONING: R -12
BLOCK: LOT: 040 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF 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: Water heater replacement.
FEES
Owner:
Type By Date Amount Receipt
HANSON, DOROTHY L PRMT CTR 12/12/01 $72.50 27200100000
c/o FINGER, ROGER A + PHYLLIS SPOT CTR 12/12/01 $5.80 27200100000
610 NW SPRING AVE
PORTLAND, OR 97229 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
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: .� , f Permittee Signature: Z"
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
DEC -11 -2001 10:52 AM Stan. the. Hot water. Man 5037610159 P. 02
,--• ‘—.1 ''/"kt ., .. / I /61, i .
°' Plumbing Per ! i • , • 1 i
i , I' Dateceooivo: I Permit
City Of d U no :� 9 -6;496 . r.� .I'�' Sewer permit no.: Building permit no.:
�� gl7Ygand Address: 13125 SW Hall Blvd, T t t197Zm1
Phone: (503) 639 -4171 ProJecl/appl. no.: Expire dace:
Fax: (503) 598.1960
L Aj S / L f Qdo e- S 1' 1.-/ A/ �• Date issued: Receipt no.:
.
i. atffl u6e approval: a 1 8 INISION cams file no.: Payment type:
I N l'l 01. Pt:ttnti i
0 1 & 2 family dwelling or acceasory ommercial/industrial Cl Multi- family O Tenant improvement
U New construction D Addition/alteration /replacement 0 Food service D Other
. I / ) l t S I I I . INI ORf11A HON 11:1: ,S( Itl:lll'I l' (tor %puti:J inl uw. c h ec kli st )
Job address: r 3 • W Desert ... , , oamrcgi Total
Bldg. no.: Suite no.;
'ow i - sand 2 1 y wellltlgs , , y:
Tax map/tax lot/account no.: �� 100 ft. for ' ootmeedoa)
SFR (1) bath
Lot: Block: Subdivision: SFR bath
Project name; /, ~ .-
S'� (3) bath �
City/county: ZIP: 7 g Z - . h addino, • : th/lutc en MiNini
p on and location of work on premises: atir'r1?'.
mises: , ., SiteutWtles:
1 � 4(. e /o2 o•" / Catch basin/am drain
Est. date of completion/inspection: - / . -c / pir1*.nITR:n . , , I . ,- I
1'I.I :BIKINI: HMV! Olt
Foottn: drain(no. n. )
Busiaess name: STAN THE HOTWATER MAN Manu Manholes
Address: P.O. Box 33157 . , .. . connector
Ci : ' ort an' State: Or. ZIP:9 Sani : sewer(no, lin. ft.) MUM
Phone: 760-2992 Fax: 7 61 -015 9 E-mail: Corm sewer no. lin. ft. MOM
GCB no.: 130755 Plumb. bus, reg. no: 26 -632PB "aterservice no. lin. ft.
Ci /metro tic. no.: 5670 Fixture or Item:
III
Contractor's representative signature: ' A .: - Ab. don valve
Print name: AMY L Pi M /%4' et Date: a ow reventar
a // Z' : ackwater v ve •
( ON I :vt1 PI'ItSON Baslns/lavato
Name: G d 14 Lis o , : washer
Address: P hwasher
State: ZIP: Drinkin: fountain(s) VIII
Phone: ,i' -$» Fax: E-mail: B .,�, : n
l) W NI :I It 'utwn:/sewer
Name • tint): oor drains/ oor sinks/hub MIN
Mailing address:
City: (State; I ZIP: ose bier
Pie ce makes IIII
Fax: E-mail: nterceptor grease trap
Owner installation/residential maintenance only: The actual installation Primer( )
will be made by me or the maintenance and repair made by my regular Roof dram (commercial)
employee on the property I own as per ORS Chapter 447.
Owner's 9i � : • � : Sink(s), b nas (i s),�vs(7
. Date: um .
I:NI:INI
lit
Name:
Address:
Phone: State: `'.
Fax: E -mail; otal •
iv<t accept area onto. pie= can luar�erloo tar 'aur Notice: This permit application Minimum fee $ 7 a • —
Yua 0 MasterCard G /qZ
t and expires if a permit is not obtained Plan review (at %) $
within 180 days after it has been State surcharge (8%) .-- $
/ Ii . ar ! i ' co any end accepted as complete. TOTAL $ , ? Sp�
.. . ' S
Amami
4444616 (E OM) '
t,
CITY OF TIGARD BUILDING INSPECTION DIVISION 4411b 24 -Hour Inspection Line: 639 -4175 '. Business Line: 639 -4171 MST
BUP
Date Requested AM PM BLD
Location / d0 30 t3ri --1 Suite # MEC
Contact Person Ph /' , � _ & � PLM 6 T >/ 6s
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation p�
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
< SQ PART FAIL
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 [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ I Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date / Z - / 7 - !9 / Insp 7,./1 t ` 1 / e i E x t
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.