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1 445 SW CRESMER DR
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - -----
I3UP
- Date Requested AM PM BLD —
Location—_—' `' -�7 S �, L=S�/r���'/� 31' suite � MFC
Contact Person _— Ph _—_ PLM
Contractor -- Ph SWR
BUILDING_ — -Cenant/Owner I-LC
Retaining Wall
EI_R
Footing Access: ' yr N u r
Foundation C - / FPS
Fig Drain (� ----- SGN
Crawl Drain Inspection Notes: �_'11; ---
Slab
Post&Beam - -- ------.____. ------.—_..-- SIT ___--
Ext Sheath/Shear
Int Sheath/Shear ----_-- -- - ---
Framing
Insulation ------------------- _._.__
Drywall Nailing
Firewall
Fire Sprinkler —_
Fire Alarm I i --- --
Susp'd Ceiling
Roof
Misc: -
Final - - ---
PASS PART FAIL
LUMBIN
Post&Beam _. ---- --- ----- --
Under Slab a -
To OUL
ter,, efi rvi e
Sanr w e r --
Rain Drains
rn ---
SS PART FAIL
LAICAL.
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 FAILSITE
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 acct -s
ADA
Approach/Sirirmalk
Other _ C)ate = _� Inspector ��! I �� �' _M Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site=.
CITYOF `I"IGARD -PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2001-00382
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE. ISSUED: 8/14/01
SITE �DnRESS: 13445 SW CRESMER DR
PARCEL: 2S102CC-00305
SUrSDIVISION: CRESMER HILLS ZONING: R-4.5
BLOCK: LOT: 004 JURI'PDICTION: TIG
CLASS OF WORK: ALT 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: 125 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of approximately 125 ft. water line. _
FEES
Owner: --- -
Type By Date Amount Receipt
HAQUE/ROBB INS — --
1628 SE ALDER APT. 77 PRMT CTR 8/14/01 $101.40 27200100000
PORTLAND, O 97253 SPOT CTR 8/14/01 $8.11 27200100000
Total $109.51
Phone 1: 503-6172-9350
Contractor:
AQUA PLUMBING SERVICES
5769 SE 117TH
PORTLAND, OR 97266 REQUIRED INSPECTIONS
Phone 1: 503-760-6b`18 Water Line Insp
Reg #: Final Inspection
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 SE1 forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules of direct questions to OUNC by calling (503) 246-1987.
,�' �,--
Issued By: . ,� �� Permittee Signature. / ALI
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the sept busin s day
Plumbing Permit Application
--- �� _ Pe Datereceived: / U) Permitno.. I
Gity of Tigard Sewer trait no.: Building permit no..
Address: 13125 SW Hall Blvd,Tigard,O
City of Tigard Phone: (503) 639-4171 ProjccUappl.no.: Expire date:
Fax: (503) 598-1960 Date issued: Byfp
Receipt no.:
Land use approval: Case file no.: Payment type:
t
a I &2 family dwelling or accessory U Cununercial/iu.lu urial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Food service U Other:
1
Job address. ; Deacri rLtion O . F'ee(ea.) "total
New 1-and 2-family dwellings only:
Bldg.no.: Suite no.:
(includes 100it.[preach wility connection)
Tax map/tax lot/account no.:
SFR(1)bath
Block: Subdivision: SFR(2)bath —�-- - ---
Project name: ' SFR(3)bath _--
City/county: :IP: _-1 Each additional bath/kitchen - --- --
Deycript'on and location of work on premises. Slteutllitiew -
(404 1il Catch basin/area drain
Est.date of completion/inspecii:n: Drywells/leach line/tm:rch drain -�
tsionossoll Footing drain(Po.tin.ft.)
Manufactureu home utilities _
Business name: Alva the Manholes -
Addn:ss: Rain drain connector _
City: j .1 _ L, tate 'LIP: 1,72 jj' _ Sanitary sewer(no. lin.ft.)
Phone:-50 GTS-ME-, E-mail: Storms sewer(no.lin. ft.)
CCB no.: Plumb.bus.reg.no: _ Water service(no. lin.ft.) j
City/metro lic.no.: Fixture or Item:
Contractor's representative signature: r --" Absorption valve
Print name: i
[At e: Back flowwenter -_
Backwater vaEve
Basins/lavalory
Name: {Q Clothes washer _
Address: Dishwasher
Drinking fountain(s)
City: 4 State )� ZIP: Ejectors/sum
a Phone:�r"" ax:— I f mail Expansion lank -- -
Fixture/sewer cap
Name(print): I=-,M �t,'C .F_l f/ r /� noor drainsllloor sinks/hub
W 4
Mailing address: Garbage disposal -
Hose bibb
City- State: I ZIP: f Z2 iO.'_ Ice maks r
Phone: 7jrax. I E-mail: Interceptor/grease trap _ —
Owner installation/residential maintenance only: The actual installation Pritncr(;)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on die pit) I own as pj�rtOR C�hppter 447. Sink(s),basin(s), ays(s)
Owner's signature: / r Uale: . �� Sump _
Tubs/shower/shower pan
Urinal _
Name: -� _ Water closet _
Address: — Water heater _
City: - --- _ .State: ZIP: _ Other:
Phone: 1'ax: E-mail: Total
Nd all Jurisdictions accept credit cads,view call jurisdiction ror more inrornwion. Minimumfee................
Notice:This permit application
U Visa U MasterCard .__Plan review(h! . %) $
expires if a permit is not obtained -
Credit card number.— - -
Expires within I BO days eller it has been
State surcharge(8%) ....$ �
—-- -
P acc.pled as complete. TOTAL .......................$ I 1,
Name of cttrid•tohler u shown on credit card p
S
Crdholder signature Amount
4404516(t10a/COM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellingsonly: - 1 e
9 —I-------- I i
FIXTURES (individuate QTY ea AMOUNT_ (includes all plumbing fixtures in PR'iCE TOTAL
Sink 1660 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60
for each utillty connection
----- — ---- --�-- --- -
-___ One 1 bath _ $249.20
Tub or Tub/Shower Gomb, 16.60 Two 2 bath _ $350.00
Shower Only 16.60 Three(3)bath _ _ _— $399.00
Vater Closet 16.60 --- -- —_
_ SUB"OTAL i
Urinal 16.60 8%STATE SU12Cr1ARGE
Dishwasher 16.60 PLAN REVIEW 25%Or SUBTOTAL
Garbage Disposal 116.60 — TOTAL
Laundry Tray 16,60
Washing Machine —�— 16 60
Floor Drain/Floor Sink 2" 16.60
3" 16.60- PLEASE COMPLETE:
4" -- 16.60
,31er heater O conversion O like kind 1660 W Quantit b Work Performed
Sas piping requires a separate n echanical Fixture Type: New Movad Replaced Removed/
permit_
MFG Home New Water Service 46.10 Sink
MFG Home New San/Storm Sewer 46 4r± Lavatory
Tub or Tub/51-ower
Hose Bibs 16 60 Combination
Roof Drains 1660 Shower Only
Drinking Fountain 16.60 — Water Closet _
Other FixLtres(Specify) 16.60 Urinal - - -
-_— Dishwasher _
Garba2ee Dis osal
Laund Room Tray
Washing Macnine -
-- - Floor Drain/Sink: 2"
Sewr+• 1;-tloo, 3"
Sewer-each additional 100' —46.40 4"
Water Service-1st 100' 55.00 Water Heater
Water Service-each additional 200' —46.40 Other Fixtures
_ — -- --
Storm 8 Rain Drain-1st 100' 55.00 (Specify)
Storm 8 Rain Drain-each additional 100' 46.40 T� —
Commercial back Flow Prevertion Device 4640 — -
Residential Backflow Prevention Device' 27.55 - --
Catch Basin 16.60 -- -
Inspec'• n of Existing Plur,,bing or Specially 7250
Requested Inspections _ per/hr — COMMENTS REGARDING ABOVE:
Rain DraA,single family dwelling 6525
Grease Traps 1660
QUANTITY TOTAL. ---- � --
Isometric or riser diagram Is required If �— ----
Quantity Total is >9 _ -- -- -- --
—"Sl1BTOTAL --
- 8%STATE SURCHARGE
"PLAN REVIEW 25%OF SUBTOTAL —
Required only it fi-Iwe n', total is>d —
TOTAL $
"Minimum permit fee is$72 50+8%stale surcharge,exce� sidentiai Backflow
Prevention pevice.which Is$3e 25+B%state surcharge
""All New Commercial Buildings require plans with isometri,or riser diagram and
plan review
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