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\� CITY OF TIGARD _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00028
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/31/02
PARCEL: 1 S126DC-05100
SITE ADDRESS: 09365 SW LOCUST ST
SUBDIVISION: LEHMANN ACRE TRACT ZONING: R•12
BLOCK: LOT: 002 —_ _ JURISDICTION: TIG
CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: 1 RAPS:
STORIES: 1 WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 2
?UB/SHOWERS: 3 SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Repipe hot water lines in house. 2/1/02, adding (7)cold water fixtures to this permit. Other fixtures are (2) hose
bibs. ---
FEES
Owner: — ---- Type By Date Amount Receipt
LOOS, HARRY AND BEVERLY A 5PCT CTR 1/31/02 $6.64 27200200000
9365 SW LOCUST ST PRMT CTR 1/31/02 $83.00 27200200000
TIGARD, OR 97223 PRMT CTR 2/5/02 $116.20 27200200000
5PCT CTR 2/5/02 $9.30 27200200000
Phone 1: Total $215.14
Contractor:
CHRISTIAN PLUMBING INC
DBA CROWN PLUMBING
5429 SE FRANCIS REGIUIREO INSPECTIONS
PORTLAND, OR 97206 ------- _------_-- -
Rough-in Insp
Phone 1: 771-944:+ Final insnechon
Reg #: LIC 42671
PLM 34-70pb
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
1 his 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 i Iles adopted by the Oregon Utility
Notification 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) 2413-1987.
Issued By: 'ti ��-� -t,; c-LC r- Permittee Signature:
Call (503) 6.0-4175 by 7:00 P.M. for an inspecti^n needed the next busine.... day '-
FEB-01 -2002 11 : 22 AM CROWN, PLUMBING 503 771 9454 P. 01
Plumbing W on
Dote received: Parmit no.: ,Q _
City of Tigard Sewel perrllll no — Building peri it rill
Address: 13125 S Hall Blvd. li'igard,bR 9_7`2�' --- —
Ciryof7ligard Phone: (503) 639-4171 ProJecuappl,llo vxpiredatr
C1'fY Ulf !K><
Pax: (503) 598.1960 RLTI.LDIN0 DTMON Date issued: i Hy: Rrrript nn
Land use approval: Case file no.: Payment type:
:�I:
family dwc-11-ag or necessory ❑Commerrial/industrial U Multi-family U Tenant improvement
cunstrlrctiun Addition/aitera(i<n✓replacelurnt U!'ax1 service
Job ad_drem: 5G—) k0 CA1 :.1 1 Description Qty ree(!L.L Total
— New 1-au �amllydwrllingsoidy:
Bldg.n0.: suite nn.: -_-- __ (im"udeo140 n.for rwt•h rnllity ronn",tion)
Tax map/tax lot/account no.: SFR(1)bath
Lot- Block: jubdivision: SFR(2)bath -
PmJect name: t7nS _
-7SF
City/county: -1 ZIP: 11 Is -•:h additional hatly'kitchen
Des peon and Yocatiqq of work on prcmiars: T. 8111o1111tw:
— t xL&r nLryb; AL M20a-oh;;i4lufactumd
h basin/area drain
F%1.t. tale of completion/impection: wdWleach linc/ttench drain
F(x)ting drain(no.lin.ft.)
Rnsiness tome: (' onto utilities _—
Y t7 tti?W N l t w.io +-q --- - ci
Address: J yJf,)C- F_ra-►.¢.r's `at. YFtinrn ncTT-connector�T
City: w -J _ - late' /Z ZIP: gz7V(p tillniln ac wee no lin.ft—.) --
S -
Mrone:e 1 t Pax: y Email: i►orm sewer(no.lin.ft.)
CCB no.: 7_>J1 k I Plumb.bus,reg.no: _5 Willer.,; nu.lin.tt.
`tri
tylie.no.: ( - - — Fixture or item!
Cunnrnrttx'i re esentative a[gnatu :
Absorption valve
- - ac ow preventcr
stint iiente; k mar ate: -� Backwater valve - -
13aain avatory
Name: -
Addrrv4:
(�ity� ----_ - Stele: 'LIF: - ung uuv(junks)
Phonc; Fax: E-mail: P Expan sion tan -
Fixture/sewer ca
11(xw dtaina/floor sTnkAub --.._. --- - ----�-•--
Name 0 m : -tv e-r-k �"o 5 s--�—� -
- 7i trhngc i4[x)Racl I
Mailing address: ��� e.; L. -- - -
Hose
City: 31AIt: ZiP: _ Ice mTt -
Phone: t Pax', E-metil: — fpterceptorlgrcaee neap --
Uwner inatallation/residcntial rnlinrenance only: The actual installation Prtmer(s)
will be made by me or the maintenance turd repair made by my regulnr Roof drain(commercial) _ -
employee on the proptrty I own as pet ()RS Chapter 447, —s:,tk(s),basins , ays(s)
owner's signature: Date: S _
futra/y- d tw�an
Name: l nna
Addteer — uter o octet
7n --_r_—
—��� icrTtcnlerf
cit 1�.1^'ate: - ZIP: _L1a.V(
Phone: — —1i ax: $-entail: -- Total
-- Minimum fre.............. .$
Not all iwirrlichoM axape teat e,uJe,rdr.�call ludrtlrlun f.�r rode frlrarle,aYw. - w
1Votiae:"Ihia prnnit eppbcatinn plan review
VIRS (.nMealerCenl (at __ 91•) 5 -
erplrre if n teen;!i.n�rl ohtnined
eeYd m,mea �_J �Q2�JL �►�. State aurrhargc(N'ir,) S
B P vnUlin IRU days eller it hes seen —
r+:mo n7caanote r u rt wo a�cirdN
ad a ecnepte d a.9 campletr TOTAL .......................$ s
_ f
_ae'1tlf° OWN (AetICOM)
CITY OF TIGARD 24-Hour
BUILDING Inspection Line (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
_ BUP ----
Received _ —Date Re uested. AM __ PM.---_-__ BLIP
Location ___ ._ 3 -� �-t� c a _ -.Suite _ MEC
Contact Person — _ —_ Ph( -) ���' PLM
Contractor___ __ —_ Pn ( ) _ _ SWR
BUILDING _ Tenant/Owner - _ ELI:
Footing
Foundation ELC
ACC@138:
Ftg Drain ELR
Drain
Inspection Notes: '~ SIT -
F„t - Beam -- _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ----- -- -
Fire Alarm
Susp'd Cbiling --
Roof
Other: - — — ------
Final
PASS PART F - - - -
PLUMBING --—
Post&Beam - --'—�--+ --- ----
Under Slab
Rough-In
Water Service -------
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain -- -
ShowerPan
Other: _--.-
ffrnV
PART FAIT. --------------------------
QFt
lHANICAL_— - — ---- — --- ----
Post&Beam
Rough-In - -
Gas Line
Smoke Dampers ------ -
Final
PASS PART FAIL --- - --
ELECTRICAL
Service ---- -- —•-- -
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE [] Please call for reinspection RE:_.._ _ Unable to Inspect--no access
Fire Supply Line _
ADA cr !
Approach/Sidewalk Dat �_ �_�— Inspector / -�'?llL��_ -_-_ __ _ Ext
Otter:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
JAN-30-2002 11 : 37 AM CROWN. PLUMBING 503 771 3454 P. 01
/ I
Plumbing Permi 1 c n
., Detcrcx,elvedl s Permit no,; '
City of Tigard sewer permit Building Permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City of Tigard Project/appl.no.: Hrtpiredate.
a, Phone: (50.3) G39 4171 -- ---
Fax: (503) 598-1960Dateisxued: B ecel tno.
C11-Y UP i k,��1KU ��. - y` 1- p
Land use appruval: 3LMDIN(3 I)TM(W cIiftr file no. Payment 1)Iw�.
I r&2 family dwelling ur accessory U t' rnuncrcinl/i ufuscrtal U Multi-family J Tt'n,utt improvement
Ncw construction LI AJill lion/al ler ntwrt/n:pincenlent U Hood service J tither:
Jrd,ncich>res - (I-) f.c,C estil�rl tion Qty. ltlee "6 Total
Bldg.no.: Suitt Ito', -^�r t•w t %-n=- utly dwellings only:
(Include"too It.For each trlilif Y ramrw tion)
Tax map/tax lot/account no. — SFR(1)hath
UK: Block: -- Subdivision- SPU(2)bath _
Project AMC! S_ ()bath - _
Cityi'rnunt :.r n✓r//l tA'o ?ip. `x;-3 F.lich a itional bat itcl)en —
Deactipllon and ocation of work cin premiseF:_ S11te utilities:
j e-t��-1L_ -_ Catch basin/area drain
—- - — '-— rywv eac t line./trench Aram -
lsl.dale of completiordinspection:
Fcx>'ling dmin(no.lin.ft.) s
Manufacture u
home u _ues
Business name: � r� ) !1 C✓Of 'nJWen-_ oFes -
r -- --
Addreac• _ Ratn mi i�connec:tor _
�. � " _fin_- ---
City: Statc: ZIP: ;tp Sanitary sewer(no- lin. It j -- -
Phone: 2!-y y i ax: 9 E mail: _- Sturm sewer(no.lin.fl.) -
(xD no y,� / _ Plumb,bus_Mg n1x 3y-7o�C3 Water {ce no lin.fl.)
City/metro lie.no.: I y 3 ( Fixture or Item:
contmetoes mpresentative signature: Abyur tion valve --- - ---
_ Lick flow preventer ___
Print name: Vl,1 u r 1)�,,,/1l• u. bale: o--n2 13m,kwater valve-
Nam
alve_ --
Bncina/lavat __ .Z
Name; �, aI 1 I�. Clothes washer
- ' �_ '
Address. Hokin fountain(s) —
City_ Slate: I — L'jecaue/sumP _
PJfone: I'ux B mail: fix ,anslnn lank
ixttn sewer cat —
-�-- --
Name(print): ( oor dratn�toor sl u
_-- -__ r Garb„ r die sa --
Wtiling address: osc hibh
City; _ _ Sttdac , ?IP lxmaker
Mtwte t Fax: E•tntul: MarceQto grease trap
Owner rnsiallationirmidential tnuintenancc only. The nctunl irxcallation Primer(s)
will be made,by me or clip rnainlcnunre Lind rcpnit made by my rrp,ular 1K00f,draiit(commis a�^
employee on the property 1 own ns per()RR chaplet 447. ink(s),bnsln(s), avx(s) err•GO r6
Uwnws s' nature- Sump
Tuhs/ehower shower pan 21e,
�)rinal --
Harm. -- titer cloftcl _
Address: _-_ _ _ asci heater
City: State: IZI_ — tither• _
f'itonc: Fns f�tnall: abt _
Not ill Jurirractkru rcepf t9rilir k.pi he a r.�hmmtrH;` Minim Ertl f.�C................
Notice-
I. perm,[application Platt rcvi,;w(at
i-fillf ill
XV, it
Uhl acoeIn 1 sa cornpl ter it f nht well —
p r" State surcharge(It%)....$
Crcdtt Bud, A t, p within 180 dryv eller II h>ra Ixr.n
�t �' )OrrWPw TOTAL ......................5
r own m read
an urlrk errs � , 4QId16(eAIGcOM)