InitiallyGood 12000 SW BurIcrest Drive
CITYOF TIGARD PLUMBING, PERMIT
y DEVELOF HENT SERVICES PERMIT#: PLM2002-00194
1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/31/02
SITE ADDRFgS: 12000 SW BURLCREST DR PARCEL: 13134CA-02600
SUBDIVISION: BURLWOOD ZONING: R-4.5
BLOCK. LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS, TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAM S: SF RAIN DRAINS:
SINKS: 1 URINALS: 0 GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB/SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of new plumbing fixtures. 1sink, 1 washer, 2 lays, 1 tub/shower, 1 water heater, 1 backflow
preventer.
Owner: — FEES
—– Type By Date Amount Receipt
NORRIS, GREGORY A + JENNIFER K PRMT CTR 5/31/02 $127.65 27200200000
12000 SW BURLCREST DR 5PCT CTR 5/31/02 $10.21 27200200000
TIGARD, OR 97223
Total $137.86
Phone 1:
Contractor:
OWNER
REQUIRED INSPECTIONS
Rough-in Insp
Phone 1: PLM/Underfloor
Reg #: Top-out Insp
RP/Backflow Preventer
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Cedes 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 18plays. 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 niay obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day
"fumhing Permit Application
D ..City Of Tigard �IU2 Permit no.: -00
A4., k -
Address: 13121 SW Hall Blvd.Tigard,OR 97223 Sewer permit no.: Building permit no.:
0. y of Tigard Phone: (503) 639-4171 Project/appi.no.: Expircdntr,. -
Fax: (503) 598-1960 Date issued: Bjj Receipt no.:
Land use approval: _- _ _ - Case file no.: Payment type:
O 1 &2 family dwelling or accessory U Commercial/induslr'jal U Multi-family O Tenant improvement
U New construction1*Addiiiop/alteratioii/ieplaccrnenl U food service Ll Other:
t t
Job address: �j-y y� e'� ) Descri !1011
1��_�x. F-4.r,�•�.y P _ Q71'11( Total
Bldg.no.. �`tlite no.: Neto I-and 2-family dwellings only:
Tax map/tax lot_eccotiat no.: '— — (Includes lOO ft.ft)re;.cli titilityconn,;liun►
SFR 11)hath
Lot: -_ Block: Subdivision: SFR(2)baut — -- -- ---
Project name_. SFR(3)bath -
City/count): ZIP: -7 2-2 Each additional bath/kitchcn _ -
Description and location of work on premises:_ Siteadlitlem:
Catch basinlarea drain
Est.date of completion/inspection: -' D wells/leach line/trench drainLO —
Footing drain(no.lin.ft.) -
Business name ��1d1 N� 2 Manufactured home utilities -_ -- —
-- _ Manholes
Address: Rain drain connector
City: mState: ZIP: Sanitary sewer(no. in.ft.) —--
Phone. Fax: $_mall: Storm sewer(no.Iia.ft.)
CCB no.: Plumb.bus,reg.no: ater service(no,lin.ft.)
City/metro lic.no.: -- Fixture of item:
Contractor's representative signature: -- Absorption valve --
- -- Back flow reventer _
Print nae: Date: LJ
Backwater valve
Basins/lavatory
Name: Clothes washer (-
Address: t�CU✓ � J l�e '�—"r�i Dishwasher
City: I State.: 'LII': G{
Drink.in fountain(s)
�� Ejectors/sum,t
Plione: 0370 x4 14 Fax: F,-mail: Expansion tank _
Fixture/sewer cap
Name(print):e� .t'ut l?t G.a Floor drains/floor sinks/hub
_Mailing address: Garbage�— Garbage disposal
�� � State:C ZIP�2 Bose bier
City:
Ice maker
Phone: "U O / ax: Email: interceptor/grease t_ rap
(honer installatintl/residential maintenance only: The actual installation r(s)
will he made by me nr the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as r ORS Chapter 447. Sin (s)�sin(s),Ws(s)
Owner's signature: _ - Date: C z Sump
Tubs/shower/shower pan
Name: Urinal Water closet ----
Address: ---- /n. (
Water heater - p
City: _ _ State: too
ZIP: i Other. -
Phone: Fax: Email: Total
Na all jurisdictions weep('relii cards,please call ludsdknon rot mere information Minimum fee................$ ��7.4y
Nonce:"Phis permit application
U Visa U MasterCard ,, '' t%tires if a permit is not obtained Plan review(at _ %) $ _
Crnlit card numlxY Expires
� withn.180 days after it has been State surcharge(896)....$
p TOTAL
-----.---�'---- - - accepted as complete. .......................$ / ,
Name of cardholder u shown on credit cod P R
--- Cardharder elgnaiure ----- Amount 414,616(GOEVCOM)
PLUMBING PERMIT FEES:
(-- — PRICE TOTAL New 1 and 2 family dwellings only:
FIXTURES Individual QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the flrst100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utllity_connection
One(1)bath $249.20
Tub or ub/Shower Comb — 1ti.60 Two 2)bath __ _ $350.00
Shower Only 16.60 Three(3)bath _ --- — $399.00
Water Closet 16.60 --- --
_ _ _ SUBTOTAL 1
Urinal — 16.60 8_%STATE SURCHARGE
Cishwasheri - 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 1660 _ -_—_ TOTAL — 1
Laundry Tray) — 16,60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60 —
3" 16.60 PLEASE COMPLETE:
4" 16.60
Water Heater U conversion O like kind 16.60 - Quantl�r b Work Performed
Gas piping requires a separate mocha icai Fixture Type: New Moved Replaced Remded
permit. _ -- ---- Ca
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer -� — 46.40 —� Lavator
-- --- Tub or Tub/Shower
Huse Bibs 16.60 _ Combination
Roof Drains 16.60 Shower Only
Drinking Fountain - 1660 Water Closet _
--- - - Orinal
Other Fixtures(Specify) 16.60 Dishwasher
— Garbe
-- ---�-- - -- —'- Laundry Room Tray
-- — -- — — —
Washing Machine
Floor Drain/Sink: 2"
Sewor-1st 100' 5500 3.,
Sewer-each additional 100' 4640 4"
Water Serdce-1st 100' J -- 55.00 Water Heater _
Water S^Nice-each additional 200' 46.40 (Sher Fixtures
_ (Specify)
Storm&Rain Drain-tat 100' 55.00
Storm b Rain Drain-each additional 100' 46.40 —
Commercial Back Flow Prevention Device 46.40 - ---
Residential BacMlow Preventi-m Device'
Catch Basin 1660 -- -- - J- --_
Inspection of Existing Plumbirq or Specially 62.50 -
Requested Inbpections -- perlhr _ COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 -
GreaseTraps --- 16.60 — --------
QUANTITY TOTAL —
Isometric o,riser diagram is roquired if ----- -------- --
Uuantlty Total Is >9 ��-
- •SUSTOTAL ----- - -
8%STATE SURCHARGE --- -- -—
"PIAN REVIEW 25 OF SUBTOTAL
—Requlrnd only Ir fixture qty.total It,>g — —
TOTAL $
*Minimum permit fee Is$72.50-8%state surcharge,except Residential aackflow
Prevention Device,which is$36 25 t 6%state surchwge
*"All New Commercial Buildings require 2 sets of plans with Isometric or riser
diagram for plan review.
is\dsts\forms\plm-fees.doc 12/26/01
CITY O F T�GA R,� — ELECTRICAL L PERMIT
' DEVELOPMENT SERVICES PERMIT#: ELC2002-00246
13125 SW Hall Blvd., Tiqard, OR 97223 003) 639-4171 DATE ISSUED: 5/31/02
SITE ADDRESS: 12000 SW BURLCREST DR PARCEL: 1S134CA-02600
SUBDIVISION: BURLWOOD
BLOCK: ZONING: R-4.5
Proiect Description: Installation of 1 branch circuit. LOT : 002 JURISDICTION: TIG
RESIDENTIAL UNIT TEMP 5RVC/FEEDERS _
1000 SF OR LESS: — _ MISCELLANEOUS
EACH
_
FACH ADDT. 500SF: 0 - 200 amp: PUMP/IRRIG.ATION:
LIMITED ENERGY: 201 - 4UU arnp SIGN/OUT LIiJE LT'G:
NF HM/SVC/FDR: 401 - 600 amp: SIGNAL/PANEL:
601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS _
0 - 2U0 amp: W/SERVICE OR FEEDER: ADD'L INSPECTIONS
201 - 400 amp: PER INSPECTION:
401 - 600 amu:
Ist W/O SPVC OR FDR: 1 PER HOUR:
EA ADD'L BRNCH CIRC:
601 - 1000 amp: IN PLANT:
1000 amp/volt:
_ __ PLAN REVIEW SECTION_ _
>=4 RES UNITS: -� - --
Reconnec+ ons___ SVC/F;DR >=225 AMPS: —__
Owner: —"-- > 600 VOL T' NOMINAL
CLASS AREA/SPEC OCC:
NORRIS, GREGORY A +JENNIFER K Contractor:
12000 SW BURLCREST DR OWNER
T I GA RD, OR 97223
Phone:
Phone:
Reg#:
Required Inspections
[5PCT
ype I'y Date Amount Receipt Wall Cover
RMT
CTR 5/31/02 $46.85 2720020000( Elect'I Final
CTR 5/31/02 $3.75 2720020000(
Total $50.60
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 tf 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 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to
Permit Signaturp:i
--� Issued By:
1 ,
OWNER
R
The installation is being made on property I own which Iis Lno3TAendedI for O Please, or rent.
OWNER'S SIGNATURE:
---' _ DATE
-._ CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N:
-- DATE:________,_
LICENSE NO --
Call 639.4175 by 7:00pm for an inspection the next business day
Electrical Plerinit Application
Date received: ,D Permit no. (C7
City of Tigardw ,M Project/appl.no.: Expire date:
CitynfTigard Address: 13125 SW+•Hail 131v'I,Tig+�P 3 Date issued: Receipt no.:
Phone: (503) 639-4171
Case file no.: Payment type:
q9g-1960
not
Land use approval:
&2 family dwelling or accessot 1 Commercial/industrial ❑Multi-family ❑Tenant improvement
U New construction 0 Additi altemtioaijr placement ❑Other: U Partial
h
Job address: W Bldg.no.: Suite no.: Tax map/tax lot/account no.:
17.4:Xg2 :5Block: Subdivision:
Project name: Description and location of work on premises: �i
Fstimaled(talc�+f ��nnlrlrlitrn/inspccliun: /
1 1
n Pre Max
De%cri lfon (Jt). (ea.) 'total no.ins
Business name: -- -- Nen rrsidewial-single ormuld-famtll per —_
Addrass: -- _ ____ d"elliogunicinriodesiiiachedgarage.
Cit) State: ZIP: Servicehrcluded:
�Y-- RM it .ft,or less _ 4
Phone: Fax' E-mail' F.ach additional 500 sq.n,or portion thereof
C'CB,to.: Elec.bus.lic.no: Limited energy,residential 2
City/metro Iic.no.: Limited energy,non•rcsidenlial 2
Each manufactured home or modular dwelling
`-- Service and/or feeder 2
SI nature 0. Dole electrician(required)
Hale --
Services orfceden-installation.
Sup.elect.name(print): License no: alteration or relocation:
200 amps or less _ `
201 amps to 400 amps 2
Name(print): cSP—'`56 ��'S 2
401 amps to 600 amps
Mailing address: ( �' 601 amps to 1000 arnps 2
City G.,C L St Ole 777
Over 1000 amps or volts 2
Phone: Fax: E-mail:
Reconnectcnl 1
p- y Temporary services or feeders-
P
Owner installotion:The installation is beintt made on ro tt I own Installntion,alteration,orrelocation:
which is not intended for sale,lease,rent,or exchange according to 200 amps or less 2
ORS 447,455,479,670,701. 201 amps to 400 amps _ 1
Owner's si nature'
Date: 'Sao I to 600 am a 2
Brynch rircuhs-new,alteration,or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit -
City: State: ZIP: B. Fee for branch circuits without purchase ,
_ of service or feeder fee,first branch circuit: z
Phone: Fax. E-mail: Cach additional branch circuit:
Misc.(Service or feeder not Included):
Euch pum or itrigntiou circle —--_
U Service over 225 amps-commercial .]Health-care facility Each sign or outline lighting -
U Service over 320 amps-rating r 11 tl'r2 O Hazardous location 9 Signal g rctr out or a limited energy panel.
family dwellings O Bui!din over 10,0(x1 square.feet tour or B ,
O System over 600 volts nominal more residential units in one structure alteration,or extension'
O Building over three stories O Feeders.400 amps or more *Description:
—
U Occupant load over 99 persons O Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
O Egreas/Iightingplcn O Other: _ ---- Perinspection
Submit___elate of plane vdth any of the above. Investigation fee —
The above are not applicable to temporary construction sertice. other
Permit fee.....................$
Not all)u05111Ci maccept credit cants,pl—call ludufietirat far nage infnrmntion, Notice:This permit application plan review(at — %) $
O Visa U Mnst erVard expires it'a permit is not obtained J
/__L_ within ISO days after it has been State surcharge(R96) ....$ _
Credit card number: - -
Expires accepted as complete. TOTAL .......................$
—Name i�wwd r as shown on credit card — S
('ardholder djnaturc Amount— 44(116151610aJCOMI
R
M-- - -- - -
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT i EE.S:
-- —' TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Enerby Fee...................................................... ` $75.00
Numt)er of Inspections per permit allowed) (FOR ALL SYSTEMS)
Service included: Items Cost Total `t Check Type of Work Involved:
Residential-per unit
1000 sa ft.or less _ $145.15 _ v Audio and Stereo Systems'
Each additional 500 sq ft.or
portion thereof $33.40 _ 1 ❑ Burglar Alarm
Limf-ed Energy $7500
Each Manurd Home or Modular Garage Door Opener'
Dwelling Service or Feeder $90.90
Services or FeedersL J Heating,Ventilation and Air Conditioning System'
Installation,alteration,or rolrratior.
200 amps or less _ $00.30 _ Vacuum Systems"
201 amps to 400 amps $106.85 _ 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 Other
Over 1000 amps cr volts $454.65 2
Reconnect only $66.85 _ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COhIMERCIAL ONLY
Fee for each system...................................... .................. $75.00
Installation,alteration,or relocation
200 amps or less _ $66.85 _ 1 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2
Check Type of Work Involved:
401 amps to 600 amps _ $133.75 yp
Over 600 amps to 1000 volts, Audio and Stereo Systems
see"b"above.
Branch Circuits Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuitsClock Systems
with purchase of service or
feeder lee.
Each branch circuit $665 2 Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuli $4685 HVAC
Each additional branch circuit $6.6:,
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or Irrigation circle $53.40 Intercom and Paging Systems
Each sign or outline lighting _ $53.40 _
Signal circuit(s)or a limited energy Landscape Irrigation Control"
panel,alteration or extension $7500 _
Minor Labels(10) _ $125.00
Medical
Each additional Inspection over
the allowable in any of the above Nurse Calls
Per inspection $62.60
Per hour $62.50_ ❑
In Plant $73.75 Outdoor Lan(scape Lighting'
Fees: Protective Signaling
1'-7
Enter total of above fees $
–
Other
8`/.Stale Surcharge $ 3 r S __`Number of Systems
25%Plan Review Fee No licenses are required Licenses are required for all other installations
See"Plan Review"section on $
front of application —
Fees:
Tool Balance Due $. �D'Cau
Enter total of above fees $
❑ Trust Account M 8%State Surcharge $--
Total
—Total Balance Due $--
All New Commemisl Buildings require 2 sets of plans.
i!\dsts\fbnm\cic-fbes.doc 08/30191
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)6319-1175
INSPECTION DIVISION Business Line: (503)639-4171 MST
1 BUP - --
Received _ �r _ Date Request _ _��- AM PM __ BLIP
Location � ��L(� _Suite - MEC
Contact Person _-._.._ _ -s / ,iso _ Ph(^C ) 26 5~ 7e9 0 L PLM
Contractor--_-- ---�-____-- Ph(--) SWR --
BUILDING Tenant/Owner ._. _ _-_ ELC
Pouting ELC .sillysz_.=��r��
Ftg Drain
Foundation ACCESS:
—
Crawl Drain _ _
Sla') Inspection 1�J: SIT
Post&Beam -�
Shear Anchors --- -
Ext Sheath/Shear
Int Sheath/Shear --
Framing - - - -
Insulation -�
Drywall Nailing -
�irewall
Fire Sprinkler _ -
Fire Alarm
Susp'd Ceiling ----- ----
Roof
Other-
Final
ther Final
PA - T FAIL ------------ _
os eam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains - -_ --- - -- -- - - -- - --
Catch Basin/Manhole
Storm Drain — ---- - -
Shower Pan
Other: - - --- --- --- -
PAS PART FAIL ------- - ---- - - -----
M _ANIC_AL
Post&Beam --
Hough-In - __-
Gas Line
Smoke Dampers ---------- ___ ..-_
Final
PASS PART FAIL -- ---- - _- _ —
ervice --
Rough-In
UG/Slab — -
Low Voltage
Fire Alarm
III - --
In F1 Heinspection fee of$- required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
SI - -`_ Please call for reinspection RF. -- _ -- -_ -_ _ -. ❑ Unable to inspect--no access
Fire Supply Line
f T
ADA �j/ � I C,J
Approach/Sidewalk Date ----- Inspector -
Other:
Final - DO NOF REMOVE this inspection record from the Job site.
PASS PART FAIL
BUP - Building Permit ELC - Electrical Permit
Ins ection Description Date Passed By Inspection Description Date Pa_ssed B
Footing/Setback Underground cover
Foundation walls _ Wall cover
Footin drain Ceiling covf - _ —
Wateiproof bsmt walls Electrical rough-in
—
Slab Electrical service _
Crawl drain Electrical final
Underfloor insulation
Post/beanl structurzl --- —
Shear walls/anchors ` ELR - Restricted Ener Permit
Roof nailing
Firewall - Ins ection Descri tion Date Passed 13�
Tilt-up panel Low voltage
Masonry/Reinforcement Electrical final
Framin
MFG-Structure set-up
Insulation MEC - Mechanical I'c_rmit
Dr wall nailing – Ins Lection Description Date Passed By
Suspended ceilin — Post/beam mechanical
Engineered soils Gas line
Weldin Lab Final Mechanical rough-in —
Concrete Lab Final Fire damper _
Bolting Lab Final Duct work
Structural observation Smoke detector---
Fireproofing
etector__Fire roofin Lab Final Mechanical final
Final inspection
— PLM - Plumbing Permit
BUP– Fire Protection System Permit Ins ection Description Date Passed B
Inc tion Description Date Passed By Plumbing underslab
Sprinkler underfloor/slab Crawl drain
Sprinkler rough-in Post/beam lumbin
Sprinkler final Plumbing to -out
Fire alarm final RP/backflow reventer
—f HE Rain drain
Storm drain
SIT - Site Permit Water service
_
Inspection Sanitary sewern Description Date Passed B _ Culvert/catch basin
Footings — Pum /fill septic tank
Foundation walls Plumbing final 3 U
Sprinkler supply lines
..Sprinkler underfloor/slab
Catch basin/Manhole SWR- Sevver Permit _
—..Engineered soils In
Engineering ecce fence s B tlon Description Date Passed Sanitar sewer_
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
1Adsu\farr m\tnspRecordBUP.doc 04/17/01
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00194
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/31/02
SITE ADDRESS: 12000 SW BURLCRE=ST DR PARCEL: 1S134CA-02600
SUBDIVISION: BURLWOOD ZONING: R-4.5
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STO'<iF-S: WATER HEATERS: 1 CATCH BASINS:
_ F!XTIJR:.S LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 v URINALS: 0 GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB/SHOWERS: 1 SEWER I_!NE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of new plumbing fixtures. lsink, 1 washer, 2 lays, 1 tub/shower, 1 water heater, 1 backflow
preventer.
FEES
Owner:
type By Date Amount Receipt
NORRIS, GREGORY A + JENNIFER K PRMT CTR 5/31/02 $127.65 7.7200200000
12000 SW BURLCREST DR 5PCT CTR 5/31/02 $10.21 27200200000
TIGARD, OR 97223
Total $137.86
Picone 1:
Contractor:
(� OWNER
REQUIRED INSPECTIONS
Phone 1: Rough-In Insp
Reg#: PLM/Underfloor
Top-outlnsp
RP/Backflow Preventer
Final Inspection
N
0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
pPcialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
his permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
han 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
tification 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: u Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next bus-Iness day,