Permit Plun><bing Permit Application
• Site Utilities �1` "� FOR OFFICE USE ON!'
Receisxd City of Tigflr'd ti� 9�j 3 remit'No.: CN,?0/3-00,3/i e/B•:n [3125 SR'Hall B1vJ.,Tigard,OCCA
Plan Review
Phone: 503.718.2439 Fax: 503.59 i other Permit No.:
1 C inspection Line: 503.639A175 � (� G r* Datelly: 9 -'p�-� e e 0fTa01s-4�s
T I GA It D V'� \S Dale Readymy. /� luns lid See Page 2 for
. Internet: www.tigard-or.gov ��++ V►�A� Notified/Method: ,S�y - / Supplememol Information
. , '-TYPE OF.WO 4,03/4‘,, 1,T�- • Flit° SCHEDULE;. - -
®New construction molition For special iuforwadon use checklist
Description I Qty. I En. 1 Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 R.for each utility connection)
CATEGORY-OF:CONSTRUCTION SFR(1)bath 312.70
-Cc\
❑ I-and 2-fatuity dwelling ®Commercial/industrial SFR(2)bath 437.78
❑Accessory building Sl'K(3)bailor 500,32
®hiulli•fanmily
Each additional barn/kitchen 25.02 0
❑Master builder ID Other: Fire sprinkler(_sq.R.) Page 2 w
.
JOB SITEIMFORNIATION AND'LOCATIO,N • Site utilities:
Job site address:7148 SW Gonzaga S( Catch basin or area drain 2 I 18.76 37.52
Drywall,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear R.:fl ) Page 2 125.07
Suite/bldg./apt.no.: I Project name:The Adrienne Mamfaclared home utilities 50.03
Cross street/directions to job site:SW Gonzagn St between SW 72 Ave and Manholes I 18.76 18.76
SW 69th Ave Rain drain connector I 18.76 18.76
Sanitary sewer(no.linear R.:q$) Pnge 2 62.54
Storm sewer(no.linear 0.:475) Page 2 212.62
Water service(no.linear It.:179) Page 2 _ 100.06
Subdivision: I Lot no.:0800 Fixture or item:
Tax map/parcel no.:2SI OIACOD800 Backtlow premier 3 31.27 93.81
UESCRIPT1ON:°F WORK
Backwater valve 1 12 51 12.51
Clothes washer 25.02
Parking lot to serve mixed use building and
Dishwasher 25.02
associated utilities. 1 n Drinking fountain 25.02
3 z u (-I J 404/h d,JGt 1 1.\N P(2tr��1 Ejectors/sump - 25.02_ _,---
@ PRekeir0-OYY\CR...r...-- I ❑,.TEN t'T 5 Expanslon husk 12.51•
Name: 311 o�ra S co pige,t,s1 / Floor d/scwcr cap 25.02
Address:` 12100 5 W •�y„a sA/t\ r Floor ge disposal sink/hub 25.02
�; Garbage disposal 25.02
City/State/ZIP: 1 I Q,yc( i OL 9-7 Z3 Hose bib 25.02 -
Phone:('Sp'3 ) 4,2.6 r 2,4,3 3... Fax:( ) Ice maker 12.51
.❑,APPLICANT Ca•CON'TAC -PERSON Interceptor/grease Imp 25.02
Business name:Canino Medical gas(value:S_) Page 2
Printer 12.51
Contact name:Seth Galley
Roof drain(commercial) 12.51
Address:5415 SW Westgate Dr.Suite 100 Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97221 Solar units(potable water) 62.54
Phone:(503)419-2500 I Fax::(503)419-2600 Tub/shower/shower pan 12.51
E-mail:set li.garey@carduo.com Urinal 25.02
CONTRACTOR Water closet 25.02
' - Water heater 37.52
Business name: 0-r pL \ p
��r�t (� t1�•'��f>�� ��{ . Water piping/D\W 56.29 -
Address: 115-)5 .j�'1 Akt. i.144..-y_t ;iv Other: 25.02
City/State/ZU':' 6, 2 6 972.3_3 Subtotal 681.65
1 )
Phone: 5- - f - 1 r 1 - Fax:('5,;3 (x, i Minimum permit fee: $72.50
CCB Lie.: /foci ty Yy Phnnbin Lic.no.: I %�7 Plan review (25%of permit fee) 170.41
State surcharge(12%of permit fee) 81.80
Authorized signature: TOTAL PERMIT FEE __9.33,43(7`
t�� t This permit application esptres If n permit Is not obtained within ISO days
me•
Print na • T- f
1 ( 3 F'"
'"1 otter It has been accepted as complete.
'Fee methodology set by Tri-County Building Industry Service Board.
t?BuildlnySPem,iuiPLttU•PnmilApp doe 10'01/09 410461671 Ie'02/COM YEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site'Utilities Qty. Fee(en) Total Square Footage: Permit Fee:
Footing drain-I"100' I 50.03 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 2 37.52 75.04 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer- 1st 100' I 62.54 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' I 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' 1 37.52 37.52 • -
Storm&Rain Drain-1st 100' I 62.54 62.54 Valuation: Permit Fce:
✓� $1.00 to$5,000.00 Minimum fee S72.50
,
Sloan&Rain Drain-each additional 100' $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other°lnspectipn§_or:Fees, Q'y.: r«(�') To1A1 � each additional 5100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for 510,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/ r each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first S25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional S100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first S50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result In Increased sewer fees*.
Quantity b •Fisturc Type = -Plan Review forPluln>tbing.Installations
nature Type for •Replace/
Work Performed: Capped Added. : rtelocau Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ Any new conunercial building with water service 2"and
lacuui/1Vliirtpool greater,except systems designed and stumped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex stricture
CuspidorAVaer Aspirator as defined in OAR918-780.0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex stnichire tis defined in OA R918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above,
-3"
4- Isometric.or Riser Diagram -
car Wash Drain
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-conunercial-food related
-Industrial-food related
!cc Mach/Rettig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -Non-food related _
-Bradley
-Commercial-food related
-Service
-
Swimming Pool Filter "Note: If the fixture work under this permit results in ail
Washer-Clothes p
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must st be paid before the
Urinal plumbing permit can be issued.
-
Other Fixtures:
C:\Uscrs Uinuny\AppDatnU-ocal\Microsoll\Windows\Ternporary Internet F2iles\Content.OnllookU6531ZPX1PLMU-PcrmitApp.doc
s p CITY OF TIGARD �' 4 PLUMBING PERMIT
COMMUNITY DEVELOPMENT �_�o Permit#: PLM2013 00312
T IC;A R Z7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
�'� Date Issued: 10/30/2013
Parcel: 2S 101 AC00800
Jurisdiction: Tigard
Site address: 7148 SW GONZAGA ST
Project: The Adrienne Subdivision: BEVELAND NO.2 Lot: 14
Project Description: Site utilities for new 10,900 square foot mixed-use building(2,600 ground floor commercial with 8 residential units-
8,300 square feet).315/14:Added(4)rain drains per inspection.6/11/14,Reprinted for additional fees paid.
Contractor: RELIANT PLUMBING&MECHANICAL Owner: ROGERS, ROY R
11575 SW PACIFIC HWY SUITE 219 13690 SW TWELVE OAKS CT
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503-246-1201 PHONE:
FAX: 503-246-1205
FEES
Quantity Description Date Amount
2 ea Catch Basin or Area Drain 10/30/2013 $37.52
Specifics: 1 ea Manholes 10/30/2013 $18.76
1 ea Rain Drain Connector 10/30/2013 $18.76
Type of Use: COM 78 If Sewer Service 10/30/2013 $62.54
Class of Work: NEW 179 If Water Service 10/30/2013 $100.06
Type of Const: 3 ea Backflow Preventer 10/30/2013 $93.81
Occupancy Grp: 1 Plan Review 10/30/2013 $173.54
Stories: 1 12%State Surcharge- 10/30/2013
$83.30
Plumbing
275 If Footing Drain 10/30/2013 $125.07
2 ea Backwater Valve 10/30/2013 $25.02
900 If Storm and Rain Drain 06/11/2014 $362.70
18 12%State Surcharge- 06/11/2014 $18.01
Plumbing
Total $1,119.09
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific. •• " Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct ••estions to OUNC b' calling 503.232.1987 or 1.800.332.2344.
Issu d By: Permittee Signa
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. !/
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD PLUMBING PERMIT
• ' COMMUNITY DEVELOPMENT Permit#: PLM2013-00312
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/30/2013
T I i;a R D 9 Parcel: 2S101AC00800
Jurisdiction: Tigard
Site address: 7148 SW GONZAGA ST
Project: The Adrienne Subdivision: BEVELAND NO.2 Lot: 14
Project Description: Site utilities for new 10,900 square foot mixed-use building(2,600 ground floor commercial with 8 residential units-
8,300 square feet).
Contractor: RELIANT PLUMBING&MECHANICAL Owner: ROGERS, ROY R
11575 SW PACIFIC HWY SUITE 219 13690 SW TWELVE OAKS CT
TIGARD, OR 97223 TIGARD,OR 97224
PHONE: 503-246-1201 PHONE:
FAX: 503-246-1205
FEES
Quantity Description Date Amount
2 ea Catch Basin or Area Drain 10/30/2013 $37.52
Specifics: 1 ea Manholes 10/30/2013 $18.76
1 ea Rain Drain Connector 10/30/2013 $18.76
Type of Use: COM 78 If Sewer Service 10/30/2013 $62.54
Class of Work: NEW 475 If Storm and Rain Drain 10/30/2013 $212.62
Type of Const: 179 If Water Service 10/30/2013 $100.06
Occupancy Grp: 3 ea Backflow Preventer 10/30/2013 $93.81
Stories: 1 Plan Review 10/30/2013 $173.54
1 12%State Surcharge- 10/30/2013 $83.30
Plumbing
275 If Footing Drain 10/30/2013 $125.07
2 ea Backwater Valve 10/30/2013 $25.02
Total $951.00
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance e . suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or.irect questions to OUNC b 3.232.1987 or 1.800.332.2344.
I=sued By: k... i ceie,,zz; Permittee Signature:
- ......_ dr-
44-4/. A .1:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection.
. r
Plumbing Permit Application
• Site Utilities ,1° TOR OCCICE USE ONLY ,
Received
City of Tigard (� 'l� Daten3y: 1� c1 3
Permit No.: ata0/3-O03/�
11 13125 SW Hall Blvd.,Tigard, 97223i� ^� Plan Review�j 1�
i Phone: 503.718.2439 Fax: 503.591I�c0 AKY Date/B % -�% Iher Permit No.: at rte/3-�pii
Inspection Line: 503.639.4175 G O� e
TIGARD_ �+�A,`Sl Data Ready/By: runs: WI Sec Paget for
Internet: www.tigard or.gol . NotiO nit 1ethod: Supplemental Information
TYPE OF=1 �
VO � - FEE'-'SCHEDULE _
®
t`�� information use checklist.
special in t
New construction �P7cmolition P I
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100(l.for each utility connection)
--- . --_ - -- CATEGORY OF'CONSTRUCTION SFR(1)bath 312.70 iss
❑ I-and 2-family dwelling ®Commercial/industrial SFR(2)bath 437.78
•building SFR(3)bath 500.32
❑Accessor} 4
g ®iViulti-family
Each additional bath/kitchen 25.02 O
❑Master builder D Other: Fire sprinkler(_sq.R.) Page 2 w
JOB SITE INORMATION AND LOCATION-.., Site utilities: I
Job site address:7148 SW Gonzaga St Catch basin or area drain 2 18.76 37.52
Drywell,leach line,or trench drain 18.76
City/State/ZIP:Tigard,OR 97223
Footing drain(no.linear R.:275) Page 2 125.07 Si
Suite/bldg./apt.no.: I Project name:The Adrienne Manufactured home utilities 50.03
Cross streeUdirections to job site:SW Gonzaga St between SW 72°d Ave and Manholes I 18.76 18.76
SW 69't'Ave Rain drain connector 1 18.76 18.76
Sanitary sewer(no.linear R.:y$) Page 2 62.54
Storm sewer(no.linear ft:475) Page 2 212.62
Water service(no.linear 9.:179) Page 2 100.06
Subdivision: I Lot no.:0800 Fixture or Beni:
Tax map/parcel no.:2S101AC00800 Back-flow preventer 3 31.27 93.81
DESCRIPTION-OF,'1VORK Backwater valve aL I 12.51 12.51
Clothes washer 25.02
Parking lot to serve mixed use building and Dishwasher 25.02
associated utilities. Drinking fountain 25.02
Ejectors/sump 25.02
0:PROPER_T1 O llrrNER _ ❑"TENANT, Expansion hulk 12.51
Nacre: F ly 0kr, S. CO�iiV4.17 Fixture/sewer cap 25.02
Address: in?00 s w 72.A Avg r Floor ge disposal sink/hub 25.02
Garbage disposal 25.02
City/State/ZIP: l l �.-c( 1 0,_ 9 2,2,3 Hose bib 25.02
Phone:5)3 ) 6-2_, ,, _ it,3 L. Fax:( ) Ice maker 12.51
❑,APPLICANT '- `, -:- --_ - _® CONTACT'PERSON Interceptor/grease trap 25.02
Business name:Canino
Medical gas(value:$ ) Page 2
Printer 12.51
Contact name:Seth Galley
Roof drain(commercial) 12.51
Address:5415 SW\1'estgate Dr.Suite 100 Sink/basin/lavatory 25.02
City/State/ZIP:Portland,OR 97221 Solar units(potable water) 62.54
Phone:(503)419-2500 Fax::(503)419-2600 Tub/shower/shower pan 12.51
E-mail:seth.gnrey@carduo.com Urinal 25.02
- - ._ _- - - CONTRACTOR -_ _ Water closet 25.02
- Water heater 37.52
Business name:
174L / IJ ,- p,_„„46,I0
62 Hko•l.L, Water piping/D1W 56.29
Address: I 4 3 2 5 1 . Pitt, j.14.4.:4_Tit_.a15! Other: I 25.02
-
City/Stale/ZIP:-; 4' 1 6,2 9720_3 Subtotal 681.65
Phone: j - ( ° 1 Fax:( /(�--, c�J Minimum permit fee: $72.50
i
Plan review (25%of permit fee) 170.41 I
CCB Lie.: /( (g yy Plumbin Lie.no.: , PPS//7 State surcharge(12%of permit fee) 81.50
Authorized signature: TOTAL PERMIT FEE _,32-16---
Print name' A. Date: This permit application espires If n permit Is not obtained within t80 days
�a911V\FS .N. J + � i ( 3 after it has been accepted as complete.
"Fee methodology set by Tri-County Building Industry Service Board.
CUruil ding'PermitsIPL5[ll-PermitAppdoe 10.'01109 410-4616r(10'O2/CO\0\YEB)
Plumbing Permit Application - City of Tigard
• Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
.Site"Utilities - Qn'• ree(ea) Total Square Footage:- •Permit Fee:
Footing drain-I,'100' I 50.03 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 2 37.52 75.04 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer- 1st 100' I 62.54 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 1 62.54 62.54 Medical Gas Systems:
Water Service-each additional 100' I 37.52 37.52
Valuation:_ Permit Feer_:; - •
Storm&Rain Drain-1st 100' I 62.54 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Stone&Rain Drain-each additional 100' 4 37.52 150.08 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
• each additional 100 00 o fraction thereof,
- - - - °.Total t na r to
Other°Ins eetions or-Fees, Qiy._ ree.(e�):._
p - - - - - -- and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/br $25,001.00 to$50,000.00 S379.50 for the first 525,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Rcinspection Fees 90.00/br and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quanti by Fixture Type` . Plan Reviewfor.Plumbing:Installation5
Fixture Type for "Replace/ Plat]review is required for an of the following.
11'ork Performed: . • Capped Add ed _ Relocate )'
Baptistry/Font Please check all that apply.
Bath Tub/Shower ❑ Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
CuspidorAVater Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain Isometric olr�2iser Diagram
Garbage Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach/Refrig.Drains
Oil Separator(Gas Station) Continents regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lay -Non-food related
-Bradley
-Commercial-food related
-Service
Washer Pool Filter *Note: If the fixture work under this permit results in an
Waher sher-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\Jimmy\AppData\Local\Microsoft\Windows\Temporary Internet 2iles\Content.Outlook\6531ZPX\PLIMtU-PcrmitApp.doc
•
•
•
Site Utilities — Plumbing Permit Application
Plan Submittal Requirements
:TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer,storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional,drawn
to scale)labeled with:
A. ® map&tax lot# ® project name ® site address ® suite number
® zoning ® applicant name ® phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS -Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and geld drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying.cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
•
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size, type of material, slope of piping, manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
1:1 Building\Permits\Pl.MF-PermilApp.doc 12/30/05
-CITY OF TIGARD
BUILDING DIVISION ,..
PERMIT it.
13125 SW Hall Blvd., Tigard, OR 97223
A ..----
DATE ISSUED:
Phone: (503) 639-4171 ./47/41/ini ill\
' ,.,-Xlak-:.71.. ,1
Inspection Requests (24 Hrs.): (503) 639-4175 l .
• A
; .
INSPECTION.WORKSHEET FOR DATE: TIME: "-PAGE:
- • ';,7,1
. 1.i
SITE ADDRESS: 7/ ...' K 5.-,..- 6 ../2,-,4-6.-4- CLASS OF WORK:
SUBDIVISION: , LOT#: TYPE OF USE: ;CI
,_.
PROJECT NAME:
DESCRIPTION: .;
PHONE #: ti
MNER. o t"/4/2 /7 ,1 / s'..•• / ,-,,.,,l' i/
CONTRACT° : (
..,A,
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.:,
Inspection Request Scheduled Fort Date: (/-/5--/ ) Pour Time:
, 1
Code # Inspection Description Confirm # Contact # Message
3''10 1
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Corrections/Comments/Instructions:
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0 PASS ' 1-P4RTIAL APPROVAL 0 CANCEL 0 NO ACCESS
0 ,FAIL 111 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
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Inspector
,• . if-;:,4I,::4 a
: •
Date: / /I- (4--;-. l --' Phone #: (503) 718-
7 ' 1.'' I -
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•.;.,:_l:.Q4„,__..,,,,..,..,.-,,, ., „,i. „ . , _ _ , _ _
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Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7148 SW GONZAGA ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
PASS - No C of O
PLM2013-00312
George Heimos
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7148 SW GONZAGA ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
November 13, 2014 at
11:07:54 AM
PLM2013-00312
George Heimos
1. Expose back water valve, south west corner under 6" cap
All else ok
Recall inspection
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7148 SW GONZAGA ST, TIGARD, OR, 97223
Commercial - Plumbing
399 Plumbing final
FAIL
PLM2013-00312
George Heimos
1. Expose back water valve, south west corner under 6" cap
All else ok
Recall inspection
Violation Summary:
Inspector Contractor