Permit �
CITY OF TIGARD PLUMBING PERMIT
lei" DEVELOPMENT SERVICES PERMIT #: PLM2004 -00438
A II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/20/2004
SITE ADDRESS: 12760 SW WATKINS AVE PARCEL: 2S1026C -04100
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: R -4.5
BLOCK: LOT: 031 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 65 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water service.
FEES
Owner:
Description Date Amount
2 760 SW WATKINS AVE , RICK
12760 [PLUMB] Permit Fee 9/20/2004 $72.50
12760 S
TIGARD, OR 97223 [TAX] 8% State Surcharl 9/20/2004 $5.80
Total $78.30
Phone : 503 260 - 6082
Contractor:
CASEY'S PLUMBING INC
904 NE 57TH AVENUE
PO BOX 30075 REQUIRED INSPECTIONS
PORTLAND, OR 97294
Phone : 503 Water Line Insp
Final Inspection
Reg #: PLM 26 -725PB
LIC 147298
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: y Permittee Signature: A N.
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Sep 20 04 11:22a Bill Casey 503 -262 -8251 p.1
Plumbing Permit A ' ' `: ' f4 E ® 1-01; 01:1 R F l S 1' ()NI.)
City Of Tigard Roea
13125 SW Hall Died. Tigard, OR 97213 0 2004 R4v o`I t 'ern+r N � ad y '� j � c� ��
Phone: 503.639.4171 Fax: 503.59$1 e A t , �.,; i rarellsy OUrap No.;
24- Hour Inspection Lino: 503.639.417571► Q It. J J -
Imenet: www.d.tigard.or.us v () F TI .1 N al/M'a 161 pl e meal Informs far
n 1 NohfiodiAQdhod l Supplemental um
T J_i1_ `ii - t �ISIO�, FEE* AVLE
0 New construction �' 0 Demolition For special informnagw
Description I Qty. 1 Ea. I Total
•1 Addition/alteration/replacement Q Other: New I -2 -Madly dwellings (includes 100 fL for each utility connection)
CATEGORY OF CONSTRUCTION SFR (]) bath 249.20
.1 1- and 2-family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building Q Maher- !early SFR (3) bath 399.00
Each additional hatldlcitd en 43.40
I=1 Master builder 0 Other
Hire sprinkler ( set. IL) + Page 2
JOB SITE INFORMATION AND LOCATION -
Site utilities
lob site address: c9 , , ` toQ <, L I / Catch basin or area drain 16.60 _
City/State/ZIP: - • Q Lrn D i 9" 3 DlywcIL leach line. orurnch drain 16.60
• Suite/bldgJapt. no.: Project name: Fooling drain (no. lines L: ) Page 2
Cross stroet/dircetions to job site: Manufactured home utilities 110.00
Y. Maalwles 16.60
• ,111 ` Rain drain connector
16.60
L!
p , Sanitary sewer (no. linear It: _) p 2
Storm sener(no. linear fL: ) Page 2 I
� � _
Subdivision: � I Lot no_: Water service (no. linear 1L: 6 5 ) Pagc 2 '�e
Tax map/parcel no.:
Fixture or Item
Absorption valve 16.60
DESCRIPTION OF WORK
Baddlow pm- venter Page 2
L ' A ,I A / ■ .1' a _' i 1 [ ' Badwater valve
-.r 16.60
• Clothes amber _ 16.60
•
Dishwasher 16.60
Dri
0 .1 PROPERTY OWNER Q TENANT ing fountain 16.60
n.
Fedora/sump 1460
Repulsion lank 16.60
A le '
.. 1 _ FuRiadaewv cap 16.60
-
• /1 OE no - • 3 Floor drain/Door sink/hub 16.60
Phan= (50 3 ) 2.(o v 2' Os. 2 Fax ( ) Garbage disposal 16.60
❑ APpUCANT ❑ CONTACT PERSON Hose bib 16.60
' Ice maker 16.60
Business name: 03 Q LA 'S - b _ 1 o
3 LlteroeplrxlgrCese1rap 16.60
Contact name: UL if .,
Co r V1 ) e �I Mc&nI gas (value. $ ) Page 2 �
Address: , AP 7 Primer Iraq
1460
r a , k . • 7 G} . Roof drain (comtnercir l) 16.60
Phone: (503) ZS3 - WIC) P ax:: cso.a3) z , 2,- sz's 1 sinub..hil1ay.toi 16.60
Tub/sbower/showcr pan 16.60 "
E -mail: cxAse 4 5 e11.um.b c Ca)ScYrf c a.ni- • h2.k u ,1nal
RAGTOR 16.60
Wad closet 16.60
Business name: Wafer heater 16.60
••
Address: F
► 'O -
City /State/ZIP: �y i 1
Phone. Minimum permit fee: s-n_so (9
( ) r� ( ) Residential baddlou��irn� pert Ica 536.25 '-ca
CCB Lic.: • 0 r Plumbing Lic, no.: 26,- 72 5 7 z Plen review (25% of permit fee)
Authorized signature• %' // L.Y __ C� -I"YLi G1 / / ,_ Stale surcharge (8%ofpermit fee) 5._-iV
tom-, .A
U jJ TOTAL. PERMIT FEE -7 $ .30
a • • • • . A Daft: S Ilk U ' This permit appResdan aspires if. permit b not obtained with
1110 days alter it has been accepted no complete.
CITY OF TIGARD 24 -Hour
BUILDING . Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested q °Z I AM PM BUP
Location / of ‘O E,CJ ( Suite i rU- ---- MEC
Contact Person �.c.e Ph ( ) aS3 - o () 6 PLM and " DQ q3g
Contractor
Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
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
kral5Fice
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
• • -r:
Gra PART FAIL
ANICAL
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 12 I , o y Inspector cn Ili-. Lit 1 \ I "" Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL /