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12370 SW Main St
CITY OF TIGARD PLUMBING PERMIT
3
DEVELOPMENT SERVICES PERMIT#: PLM2002-00127
13125 SW Hall Blvd., Tigard, OR 9722.3 (503) 639-4171 DATE ISSUED: 4/18/02
SITE ADDRESS: 12370 SW MAIN ST PARCEL: 2S102AB-030J0
SUBDIVISION: ZONING: CBD
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANC' GRP: B FLOOR DRAINS: TRAPS!
STORIES: WATER HEATERS. CATCH BASINS:
FIXTU_RES �e LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRADS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINAC- : ft
WATER CLOSETS: WATER LINE: ft.
DISHWASHERS: FAIN DRAIN: ft
Remarks: Installation of backflow prevention device.
_-- ----- _._------- FEES ---_._.--
Owner:_ _-
CAPISTRANO, NICHOLAS III Type By Date Amount Receipt
12370 SW MAIN ST PRMT CTR 4/18/02 $72.50 27200200000
TIGARD, OR 97223 5PCT CTR 4/1802 $5.80 27200200000
Total $78.30
Phone 1:
Contractor:
CRAFTWORK PLUMBING INC
7736 SW NIMBUS AVE
BEAVERTON, OR 97008
REQUIRED INSPECTIONS
Phone 1: 644-8698 RP/Backflow Preventer
Reg #: LIC 79666 Final Inspection
PLM 20-148PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialt� Codes and all other applicable laws. All work will be done in accordance with approved plans.
This pe mit 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 952-0001-0080.
Yob may obtain copies of these rules or direct questions to OUNC by calling (500) 246-1987.
l
ued By: f ���'GCC Permittee 3,-mature: �I _
Call .(,503) 1319-4175 by 7:00 P.M. for an inspection naeded the next business day
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Ph mbi ng 1'rermdt Applicati®n
C of Tigard
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Sewer permit no.. Buddins pe mit nooCity I
Addtees. 13121 SW hall Blvd,71prd,OIZ 97223
° hard Phone: (503)6.191-4171 NWI/appl.no-: Expire data - —
Fax: (5M) 598-1460 Datc issued. w— - -
Y Receiptno.:
band use approval: __- - Cast file no.: I payment rypc:
O 1 &2 family dwelling or acxe-saory ❑Commercial/inihignal O Multi-Wrtily ❑Tenant Improvement
O New owtntction 0 Addltiao/altenban/mplwr.njcnt '-'Food service Cl t�tllcr
lob address: tie t1�. TOW
no.: - - Sults no.: _ - a+w 1' ft a -dftp M"
Tax m W/&CCU>tntnO_- ( 186R.fbreWh%tHkYMM*edoe)
t.ok Block:A Subdivision: - SFR(1)bath
FR Prgjett,tame: (2-)
_T SFR(3)bath -
(S tc en - -
Dexdpt on and loc adon of wmk an pnsngw:
_- _ _ Catch beeWates drain
Est date of oom Woo6quttorr Dt��lIeacne/heu dentin -- -
o- t In
OnAneen nwtoa: ;,y v k anufwbAmd dome utilidesa
Addrim:
L n _n canneot�
City:
Stm: �Z� _ i sewer no.11n.fE , _ ---
Fax. E-mei: Storm sewer(no.
umb.but.M no: a Watet service(oa. tfn.fft)
-----
Cit.y/reetru lic no.: Ftxtum rt►Item
Gxttreccca s esentAtivc aiRnamte: AMor tion valve
_ -- --
Print oantc- ; — — 1: ow .venter_
[�nclrw att.r valve
Nmne
(qty. o+mtat -.—
Phono' Far �5 E--tne 1. atoea/wtn
tzP Nirisewer - -------
Name(print)_ Floor sink&ftb
MallinIt addrrm: G -
Itoae��a !'-
..i MP. .—
Qlts�oe: Fax: E-,nail: Tin,tercepwr_VrAn trap
IOwner ittata IMorthimldential maintenance only: Tule actual intdillation I'tiME s)
will be ramle by me or the maintenance and repair made by my regular Roofcomrnealalj ---- --
enilgoyex on the p►aprrty I own is pa'ORS Chapter 447. 79 ak(a),boa -
Ownaes ti Date; um _
TubaishoweiAhower�.n
Naim. rule
Addreat: -
� ater heater
Z1P
-
Pallone — ytaoC
__•y -T Fate _ L° B rtui1 � o
Ptor.nletdaces,,,seat,Pm04-etPWM am imaM Mfewroamlerermrl..' Notioc This permitapplicadtm Minimimfee................E
p N>. []MaNetC#rd expitm:f a permit is not obtained Plan review(at %)
within :00 days iftar it hu boas Sat,.turcharge(8%) --
w ..Meow w Ma crd-- - socepted ex complete. TOTAL. ........... .........$ _---
t
GIS" Y OF TIGARD 24-Hryur
BUILDING Inspection Line: (503) 639-4175
Ms•r --- -----
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP _--
Received .. — Date Requested—_- �' r AM-- PM BUP
Lncation _____-_ _ !;L-37 U _0i Suite MEC
Contact Person. - .,- Ph(---) e1 -- PLM ' �1 �
Contractor _-- —_—� Ph SWR -- --
BUILDING Tenant/Owner __—__.—_ ELC
Footing ELC
Foundation
Access:
Fig Drain IELR
Crawl Drain _ --
Slab Inspection Notes: SIT _
Post& Beam -- - __ -- --- - --- ----- _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - - ---
Insulation
Drywall Nailing — - 1- -- --- - -
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling — -------- -T -- -
Root
Other: — — - -- -- - --- ----
Final
_PASS_ PART FA /
PLUM@!N(i
Post& Beam --v—
Under Slab — —
Rough-In
Water Service
Sanitary Sewer
Rain Drains ----
Catch Basin/Manhole
Storm Drain _-
Shower Pan
Other
FAS` PART FALL
_41EtHANICAL
Post&Beam --
Rough-h,
Gas I ir-e
Smoke Dampers - -
Final
PASS PART FAIL -
ELECTRICAL
Service
Rough-In
UG/Slab -
Low Voltage - -
Fire Alarm
Final C' Reinspection tee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SIVE +— G Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line _ /��/
ADA �� f? inspector._—
.2 ���.0 Q �� _Ext
Approach/Sidenralk —�
Other:.___
Final - DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL