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12025 SW CARMEN STREET r N O N G�f ccc C n D 3 m z 12025 SW CARMEN ST CITYOF TIGARD _ PLUMl31NGPERMIT DEVELOPMENT SERVICES PERMIT#: PLM2004-00287 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/23/2004 SITE ADDRESS: 12025 SW CARMEN ST PARCEL: 2S103BD-01500 SUBDIVISION: CARMEN PARK ZONING: R-4.5 BLOCK: LOT: 016 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF vIASHING 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 I.INE: 50 ft DISHWASHERS: RAIN DRAIN: ft Remarks: 50'of water service, from meter to r.iain shut off _ Owner: FEES - — Description Date Amount GENELLE TIEMAN 2025 SW CARMEN ST IP1.11R1131 Pcrrnit 1-ee 6/23/2004 $72.50 12025 S, OR CARMEN I rAX] M State Surchar! 6/23/2004 $5.80 Total $78.30 Phone: 51)3-579-422(, Contractor: CROWN PLUMBING 5429 SE FRANCIS PORTLAND, OR 97206 REQUIRED INSPECTIONS Phone: 503-771-9449 Water Service Insp Final Inspection Reg#: LIC 42671 PLM 34-701113 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. � G Issued y: ��,�.,' sti _ Permittee Signature: 46 Call (503)6394175 by 7:00 P.M. for an insper;tion needed the next business day PermitApplicatt' n in City of Tigard 1.,125 SW WI Blvd,.Tipird.OR 97221 Phone: 503.639.4171 Fax; 503.598.1960 24-4luurinrWfior.Linc; 15036394175 0 Sim Pa,It;'ror Inwrtiet www,ci.tIprdoru& M. Method; ....... supplemme Itus,IN maden nor-w' .10". 01K�"_A ©New Construction Demolition For sperld Informwalon ow Oka kill Total Additiorw4reratiup/replacement ❑Other: N4",,1.I-fbmlly e1weillings(includee 100 ft for inch itility connection) T-: SIFF:(1)baffiTi io- I-and 2-family dwelling E)Commercial/industrial SFR(2)beth 5c,00 Aocgmry building j Multi _Faniily SFF (I)bath w DO Eac.-I additional buth/kitchen 45 00 []Mastcr builder ❑other: Fite sprinkler L.sq.ft.) I-M !2 "A Vsite utilitiesties ; Job site addros: 12025 SW CARMIN ST CAk h basin or am drain IcIl,leach linc,or trenab drain l6.i0 City/Stote/ZIP.TIGARD,OR 97223 Foot ng drain(no.linear ft.:,F) IN$, 2 Suitc/bidgJapt.no.; Project name: Foot hoine utilities 110 4) gross-street/d—imcdons tDjob Sitt: — Man soles 6 Rain drain connector 116 0 Sanl.vy sewer(no linear It.: P�- 2 Sionii sewer(no,lincer ft.: P ig: 2 Lot t�' `iwiltcr service(no linear A Rp w 21 15T.00-i Subdivision: Tax map/parcel no.; 6.,0 ANK rptiun valve Back low preventer P Ige 2 go,WATER SERVICE,,METER TO MAIN SHUT OFF Back,vititer Naive 6. 1) Clott m washer 16.- D -6ish-ashr, 16.10 — Drinl Ing fbumAin 7 jj -A I Ejpm nVsunv EXPL q Ion tank 16.1 O_y Fixtu e/fewtir cap 16'( City/5tatej7-1P; C7- 7 ZZ Floor drain/floor sink/hub -Ph011e-—155 A Fix: Hose isib Ice Aker T in Business name: lnt6rr,j.x*r'gcaxc trap Contact Paine: M tdi%-ji gas(V'4uV$ P3 Ie Prime, i.0 Address: Roof-rain(contirimial) 1 ',.6, Sift"lOwlavatoly Phone:I Tublill I ow"/OwweF pan Urinal V.. Water-loset .0-4. fittsmcss rinnic:CROWN PLUMBING Water;;*n; A Address: 5429 SK FRANCIS STREE'r Otber. fltttbtt-to City/State/ZIP:PORTLAND,OR 97206Minimum iientift fec S71- Phone;(503)771-3443 I Fax:(903)771-9454 F-i t:,.;idcnUal backflow minfirtumpermit fee: SR.- ------------ planij,jI. (25%ofpermit cc CCR Lic.:4'571 Plumbing Lic.no.;34-70PR State surcharge(two of permit Ice Authorized signature: _ TOTAL PERMIT FEE _L V, Print name!Dennis Underwood ? Date; --i-ermit applifitic"expire! —P-11-it T;­PJt A 180 days aflti it has been accepted 91 C6"I cte- *Fcc j ielhodolop,se by I 11JOUnty Bwldinp Indusir%, ervice Board. Min, '.R 3 9 1\1 CA E)NISWnld W080 t9t,6-1LL-E09 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION p�-. ;r�nc� L;m#.. rcn,3% con..A4'?4 MST _�-- BUP _— Necoived Date Re uested AM____ PM BUP Location ^/s2 G - e'x ' -r/L-4z _�Aj;tSuite MEC Contac.Person Ph( _) -Z "!2 �r� �I_ PLM DD y-DDa�S� Contractor _ _ Ph(_ ) SWR — BUILDING Tenant/Owner ELC Footing Foundation ELC Fig Drain ACCESS: Crawl Drain ELR i Slab Inspection Notes: SIT Post&Beam Shear Anchors --- -- ----- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing ------ — — Firewall r Fire Sprinkler Fire Alarm Susp'd Ceiling — - -- _--- ------ Roof Other: --_--_--- — - -- Final — PASS PART_ FAIL - PLU11riBiNG Post 3 Beam - Under Slab - Rough-!n Sanitary fewer Rein Drains — -- - -- ---- Catch Basin!Manhole Storm Drain — ----- Shower Pan Fina _- - ----- S _ PART FAIL A-- _. ------ —_ ---- HANICAL Post& Beam -------- -------__—_____ --- _ Rough-In Gas Line Smoke Dampers --- -- - ---_.._- --- -- Final PASS PART FAIL --- - --- - -- ELECTRICAL. Service -- Rough-in UGC Slab Low Voltage Fire Alarm Final Reins ection fee of$—. _ required before next Ons PASS PART FAIL p - -- pection. Pay at City Hall, 13125 SW Hell Blvd. SITE — [� Please call for reinspection RE: _ [� Unable to inspect-no access Fire Supply Line D /� ADA Approach/Sidewalk Date_ Inspector ___-- � Ext Other: Final — DO NOT REMOVE this inspection record from the job site. PASS PART FAIL