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10930 SW Gaarde Street
CITY OF TIGARD PLUMBING PERMIT
PERMIT#: /0/112002 00397
DEVELOPMENT SERVICES
DATE ISSUED: 1U/14/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S110AA-02200
SITE ADDRESS: 10930 SW GAARDE ST
ZONING:
SUBDIVISION:
BLOCK: LUT: _ JURISDICTION:
CLASS OF WORK: AL I GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
_ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: M _ URINALS: GREASE 1 RAPS:
LAVATORIES: OTHER FIXTURES: 1
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace tub/shower valvE:
_ FEES_
Owner: -- Description Date Amount —
LIVINGSTON, BESSIE E TR �I'L.UMIiI I' it rr 10/14/02 $72.50
c/o TOTONCHY, MATTI I'LUMBI Permit I cc 10/14/02 $0.00
2651 SW OVERLOOK DR I fAX]8%State Tax 10/14/02 $5.80
LAKE OSWEGO, OR 97034
I'I'AX]H%o Stutu'f'u\ 10/14102 $0.70
Phune 1: 503-636-.45.2.7 Total $78.30
Contractor: — ——
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED INSPECTION;
Final Inspection
Phone 1: 5o.1-771-9449
Reg #: I W 42671
III R1 34-701114
This per is issued subject to the reguiati„ns contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in acco,dance 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 fallow rules adopted by the Oregon
Issued By: Permittee Signatt.tre:
Call (50f639.4_175 by 7:00 P.M. for an inspection needed the next b&siess day
OCT- 10-2002 03 : 02 PM CROWN. PLUMBING 503 771 9454
Plumbing Permit Application
r �. i i.. .,r� -Des dvW: Penni(no: DD
City of Tigard �r ' 4 Sewer permit no.: Building pormit tno.:
Address: 13125 SW'He)1 Blvd,
r
TISalt
Cityofllgard Pro)ect/appl.no.: E�xpirodata:
Mune; (503) 639-4171
Fax: (503)598-1960 4)('T Date issual: TN".t
: Jteceipl no.:
1AU0 ut;e approval: - Case file no.: type: _
;I t do 2 family dwelling or acccstoq O Cotrunerclll/inIVdustrial O wo.rimily U Truant improvement
0 Now cmtatruction A Addition/alWrnti6rdreplac eme.0L.J. „Q Elbw service U Other
lob address: /0730 )a« l �_ P., i• i Dascri rico For ca' Total
<�[,�J �{.
tildg,no.: - Suite no.:
._..._ ' - Vii'mW 2,hunUy due res rar .y:
- (indudes Roo A,for rade ulllily coun"ou)
Tax mal.Jtax lot account no,: SPR(1)bath
I.,ot Block: I 5uldivision: SIR(2)bath
Project name W%d,L I,% .F bath
Cit 1rAX of ZIP: r' at n sons �t1i%kl en --- M
Descdpuotl and 1 ativn of ur 1 on premists:_ _�-- Sit*wtintlam
j 6 � �q� r�z,. Q � Catch basin/arca drain
w ~--_j �"+— — 'Ch wells/Icac t n tmn dru n
Est.date orcutopiedon/inspection: T ---
FcxH.rn c n no.jjn.�.�_'--_�----- —
Manufacture home utilities_ —
Euaineaa mune: ��� %�u ,r r r Manholes - --
Addreaa i a .� Ran drwn connector
Cid v't L t• Starz: 7.1P: '�: Swtwy sewer(no.Lin.ft.) ------ --Phone:r —
i ..c Fax. i Ijntall: (oftrl ower fno.lin.iL
_ .
CCDao._� (�! Plumb.bus.reg.no: r�=rI0 atnr service no. ,n.
61 /metro lic.no.: r 1Flztttre or Nem:
Abau rtion va�ive
C:ontractoes m mmlive ' iic flow rreventer
�--'---- Date: Backwater
��_ ----•- -- ----- —
Mint name: Elac kwater valve_ --- _----
fieslns/iavato
Name: --
.- '�Q "yn - - Dishwasher
Addroaa: �ir'i►i�CiH fountiln s
• _ -T-State: ZIP. t: iunt
Mone: Fax: 13 mall: Eix ans on tank—
Xto sewerce
t r (xu dra n floor a n1n l:v.uF --
Name(print); 6L v Oluba a die - —
Mailino4 ddreas: - , f loco
City. ;_ - i` t.� - Sate: Zt[r '� --- oo m�Ta c°r
Phone: c ' x• - F mail: Interoe for fir_
Owner ,tttalladon/residential n,ainkunailoc only: The actual installation Me a)
wi11 be ntado by me or the maintenance and repair made by my trpular Rent o canmerccia!
employee on thr lrmperty I own as per URS Chapter 447 ays s
f)wncrs signaGua: _ _ - Dano: , um
_ rower/shuwnr >an
�I[in�-_ —
aRvir closet
7
AJdtr-ss: iter rorter
City: - State: ZIP: - _
Phone: Fax: Email: o
eau rrlsaiodoe rar ma.neto.mnron l Minirntun fee................. -
Man�uaraatn wompers t plwa l Nntioe.ihirpennitapplicration
1'len review(al _•_-_ Rr) $
vi t!MashrrQnd I expires if a purnit In not obtained t�
-/052 r within 180 clays a(tcr it has been Stec nrrrc:harge(856)....$ w.
F / accepted as wmplete. TO'T'AL .......................$
riljaatrte~�~��r1r� NO�ir6(�'CVMI
lea%k (a K e6Of ife,"'Pt,c. ba l to
CITY OF TIGARD 24-Hour —
CUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST _
BUP
Received --__._-. Date Requested _—_ - f D�a AM— PM__ _—_ BLIP — —_
Location _ —�_d3d - Suite __ MEC _
Contact Person --_ Ph(._ ) PLM 10-3!2:7
Contractor_---- - _--- Ph -9–Yq - SWR
BUILDING TWnanUOwner - _ ELC —
Footing
Foundation Access: ELC
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 FAILre
PLUMBING
Post&Beam
Under Slab
Rough-in
Water Service —
Sanitary Sewer
Rain Drains -- -_-__
Catch Basin/Manhole
Storm Drain -
Shower Pan
Oth - - -- -
a
ASS PART FAIL - --- �- - T ---- '-
MECHANICAL
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:-._ - F� Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dab y ` Inspiatot -1 -_ _ - _ Ext
Other:
Final DO NOT REMOVE this Inspectic W4iord from the Job site.
PASS PART FAIL