Permit r
1,1 -':]-- CITY TY OF F TIGARD PLUMBING PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00342
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/20/2007
PARCEL: 1S136DC-04400
SITE ADDRESS: 11945 SW 70TH AVE ZONING: C -
SUBDIVISION: DARTMOUTH SQUARE LOT: 030 JURISDICTION: TIG
PROJECT: DARTMOUTH SQUARE
Project Description: Building fixtures: Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3)
primers, (1) elevator for sump pump (4) roof drains.
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 9 TRAPS:
STORIES: WATER HEATERS: 3 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: 4 GREASE TRAPS:
LAVATORIES: 9 OTHER FIXTURES: 14
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 12 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner:
FEES
DARTMOUTH SQUARE, LLC
7165 SW FIR LOOP # 100 Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 9/20/2007 $863.20
[PLMPLN] Plan Review 9/20/2007 $215.80
Phone : [TAX] 8% State Surcha 9/20/2007 $69.05
Total $1,148.05
Contractor:
CH KRUSE PLUMBING
5802 A NE 88TH ST
VANCOUVER, WA 98665 REQUIRED ITEMS AND REPORTS
Contact # : PRI 360 -573 -4337
FAX 360 -573 -5503
Reg #: LIC 111654
PLM 37 -296PB
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 set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 2 C/ Permittee Signature 7
Call 503.639.4175 by 7:00 a.m. for an inspection that busine / day.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Applica CEIVED iS i , 6 _ met o
AUG 0 4 i.'" / FOR OFFICE USE ONLY
City of Tigard Received
)' permit No.:
V 13125 SW Hall Blvd., Tigard, OR J O ( O , Date/By: (,� PUN? 7 0o3 `f�
MQ
0 Phone: 503.639.4171 Fax: 50 =" 1 .∎' ` C-' �� Date/By: Review Other Permit No 2� 7 / 9 a
at Vt, / o ' r9 Inspection Line: 503.639.4175
T I C. n ►t D Date Ready ���p «r ��Y .{ luris: Ste rage a wr
Internet: www.tigard- or.gov Notified/Method. /O7 ) �' `e4 . ® Supplemental Information
TYPE OF WORK FEE* SCIIEDULE
Er New construction ❑ Demolition For spedal information use checklist
Description 1 Qty. 1 Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath - i 249.20 ❑ 1- and 2- family dwelling ErCommercial/industrial SFR (2) bath i 350.001_
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
/ / c7 L / S ' JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: i 3 S, (J .�f'J Ave. Catch basin or area drain 16.60
City /State /ZIP: -66 1 p e_ . 60 a2. Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: 11 Project name: ,• ✓ Footing drain (no. linear ft.: ) Page 2
���ttMa� ,�h v fi Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Water sc -.'ce (no. linear ft.: ) � P<:_e 2
' Subdivision: Lci ...y: I
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION 2y WORK Backflow preventer Page 2
vew I ' V UM la t A 1 t MQ /f. k 0.4ile. Backwater valve 16.60
b N, ` i �� Clothes washer 16.60
` Dishwasher 16.60
T ❑ PROPERTY OWNER ❑ TENANT Drinking fountain 3 16.60 ,Lf 9 0
m Ejectors /sump I 16.60 / (o . (pv
Name:
i Expansion tank 16.60
t) Address: Fixture/sewer cap 16.60
) City /State /ZIP: Floor drain/floor sink/hub �. r I f 61 16.60 /
I Phone: ( ) Fax: ( ) Garbage disposal ` 16.60
\5 APPLICANT ❑ CONTACT PERSON Hose bib 16.60 . 3 .. , A0
Ice maker 16.60
Business name: c. H. .r.u.5 el ..4 b t h Interceptor /grease trap 16.60
Contact n• •• . g Aitx \KtM121Z.- Medical gas (value: $ ) Page 2
Addre• : gS0a, In . r c 't Primer 3 16.60 49,g()
Cit, /State /ZIP: . 0 6 6 4 Roof drain (commercial) 16.60 Gr/D /y0
V �� �'' QU �` " r �� Sink/basin/lavatory L / j p 16.60 /7,6 00
one: (�� 4-,-- �3 _ 1.4-3 Fax: : ( ) 4 - 5- , Tub /shower /showe 16.60
E -mail: rib,,„( C ,c , rtn.S,c • \,,, 4-W' Ut ( • 6 p , , U rinal 1 / /
, "7l/ \ 16.60 � WJ [�
\ CONTRACTOR Water closet ` A 16.60 / Q � A` O
Business name: Water heater 3 16.60 g 7
Address: Other: GlgvNh ✓Sits -)oee ,.sP1 1 /64o
City /State/ZIP: -F+�a ii/ c•.. (-,;1.-... Subtotal
Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 �a34�0
B Lic.: x , ‘ G 6 1.1- Plumbing Lic. no.: 1 ( 0 3 - �C� / fa Plan review (25% of permit fee) ....715, O
,,
Auth1;zedsi ature:
State surcharge (8% of permit fee) ,p5
5.....4,4____ 5.....4,4____ Gi �► // 1�/__ �s TOTAL PERMIT FEE /Ng Q b
Print n. C _ (( c„, v9 / Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
r:\ Building \Permits\PLM- PermitApp.doc 12/27/06 440-4616T(10/02/COM/WEB)
•
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee:
Storm &Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof, to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
Inspection of existing plumbing or each additional $100.00 or fraction thereof, to
specially requested inspections - per hour 72.50 and including $50,000.00.
Subtotal: $50,001 and up $742.00 for the first $50,000.00 and $1.20 for
each additional $100.00 or fraction thereof.
Fixture Work:
Are you capping, adding or replacing fixtures? If "yes ", Plan Review for Plumbing Installations
please indicate work performed by fixture. Failure to Plan review is required for any of the following.
accurately report fixtures could result in increased sewer fees * . Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building with water service 2" and
Fixture Type: Replace greater, except systems designed and stamped by licensed
Previous Capped Added Existing engineer.
Baptistry/Font
Bath - Tub /Shower El New exterior plumbing site utilities for any complex structure
-Tub/Shower as defined in OAR918- 780 -0040.
Car Wash Each Stall ❑ Medical gas and vacuum systems for health care facilities.
Drive tall ❑ Any multipurpose fire sprinkler system.
Cuspidor/Water Aspirator ❑ Any complex structure as defined in OAR918- 780 -0040.
Dishwasher - Commercial
Domestic Submit 2 sets of plans with any of the above.
Drinking Fountain
Eye Wash Isometric or Riser Diagram
Floor Drain/sink - 2" ❑ Isometric or riser diagram is required for new buildings
that meet the qualifications above.
-4"
Car Wash Drain
Garbage - Domestic Comments regarding fixture work:
Disposal - Commercial
- Industrial
Ice Mach. /Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory *Note: If the fixture work under this permit results in an
- Bradley P
- Commercial increase of sewer EDUs, a sewer permit will be issued and
- Service fees assessed for the sewer increase must be paid before the
Swimming Pool Filter plumbing permit can be issued.
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
i: \Building\Permits\PLM- PermitApp.doc 12/27/06
- CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00342
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9.1;1.0/2007
Phone: (503) 639 -4171
A
Ins Requests (24 Hrs.): (503) 639 -4175 "__..
INSPECTION WORKSHEET FOR DATE: 11/12/2008 TIME: 7 :OOAM PAGE: 20
SITE ADDRESS: 11945 S/ 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: un ng Ti xtur s I Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
11)- elevator fog sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360 -573 -1337
Inspection Request Scheduled For: Date: 11/12/2008 Pour Time:
Code # )nspection Description Confirm # Contact # Message
399 iit, Plumbing final 077965 -01 360.518 -1375 N
Corrections /Comments/ Instructions:
r \
•
1 \j_qV
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSES D
l Ins ect Date: 1 /one #: 503 718 -
Inspector: d ( )
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PL M2007-00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2007
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 AAA- 1J-
INSPECTION WORKSHEET FOR DATE: •10/28/'008 TIME: 7:01AM PAGE: 16
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE ()FUSE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #: II
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 364573 -4337
■
Inspection Request Scheduled For: Date: 10/202008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 077260-01 360.573 -4337 N
Corrections /Comments /Instructions:
.— Ca f Q p �
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P J
i1r-+� C 1 (.1 1 2-o d 6 " 00 237 e4G Flo Lt_, cot , ; c �
e –Gt.w S t o ✓,'V Lt, (a, � 4 rirGG, -Z r' Oe...i L c_ .3- pfo 4.fi Ae. Ca p..v I
Ofer:e
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\, _ - ° , .4 II , r a 4 .ice – v u12-./ `-d O ,- - -r - L- e-.rr,
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
4 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cn1^' l\-P\-a- Date: 0)\231/0 T' Phone #: (503) 718-
CITY OF TIGARD •1
BUILDING DIVISION PERMIT #: PLM2007- 00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2012007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/13/2008 TIME: 7:01AM PAGE: 27
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SOUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360-573-4337
Inspection Request Scheduled For: Date: 6/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 071352 -01 360.518 -1375 Y
Corrections /Comments/ Instructions:
\\ 3k Otce..3 3- O v t ac-Ai u� � ° �dv��,ld- `rer4- .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: rn Date: (pi 13 p Phone #: (503) 718-
CITY OF TIGARD : . :.
BUILDING DIVISION PERMIT #: PLM2007- 003.12
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9 /20/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1 I ..
INSPECTION WORKSHEET FOR DATE: 6/5/2008 TIME: 7:00AM PAGE: 46
SITE ADDRESS: 11915 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360-573-4337
Inspection Request Scheduled For: Date: 6/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 070902 -01 360518 -1375 N
Corrections /Comments /Instructions:
CAA \ -u■ (. r Low Q-O0 e 0�� r,j a.-4z ✓"- {,r"C.
A - ' \ O e. 0.At k.. - A V?)L
V .I . PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector \'1 Date: Co 1 CI 0 %a Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PLM2007- 003'i2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2007
Phone: (503) 639 -4171 /P l '
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,..Volt
__..
INSPECTION WORKSHEET FOR DATE: 5/22/2008 TIME: 6:59AM PAGE: 31
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360 573 - 41337
Inspection Request Scheduled For: Date: 5/22/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
345 Culvert/catch basin 070257 -01 503.519.9347 Y
Corrections /Comments / Instructions:
3 C,. L z. M VT L tc°&,ALi `',, Lo
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ""Nt^'t I 1 1 4 '"' , Date: SI ZZ (.O " Phone #: (503) 718-
CITY OF TIGARD . :
BUILDING DIVISION PERMIT #: PLM2007- 00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9120/2007
Phone: (503) 639 -4171 /ueq�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/1212008 TIME: 7:01AM PAGE: 23
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360 -573 -4337
Inspection Request Scheduled For: Date: 5/1212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 069723 -01 503-519-9347 Y
Corrections/Comments/Instructions:
ROU l'1 +-V
ter A" Lo C �ptir �OL.Ne� � TO
Lb-„,,i—t.4. 1 r (.Jeff S I A, 6 r & �" ✓ma c r �vv`e.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Qrts Alv\^ Date: Al t 2. (U T1 Phone #: (503) 718-
CITY OF TIGARD . , - ,
BUILDING DIVISION PERMIT #: PLM2007- 00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2007
Phone: (503) 639 -4171 u h i l l
Inspection Requests (24 Hrs.): (503) 639 -4175 .., --
INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:OOAM PAGE: 43
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinikng fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 364573 -4337
Inspection Request Scheduled For: Date: 5/6/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 069411 -01 503-619-9347 N
Corrections /Comments /Instructions: '
5,ck,,,., Ac u a\ 5- - 1 ` — ol nu.- C i AL -. ✓lt , T
- ccP,'.r'
L )( e. ,s .1,-e.A.
•
❑ PASS [ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CPWvdvt..) At— Date: S/ 671 - t 7 Phone #: (503) 718-
CITY OFTIGARD
BUILDING DIVISION PERMIT #: Pt.M2007- 00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/ ?0/7007
Phone: (503) 639 -4171 1 7:'
Inspection Requests (24 Hrs.): (503) 639 -4175 `' I I..
INSPECTION WORKSHEET FOR DATE: 1015/2007 TIME: 7 :01AM PAGE: 44
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinbng fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360. 673.4337
Inspection Request Scheduled For: Date: 10/ssl2007 Pour Time:
Code # Inspection Description Confirm # Contact # • Message
305 Plumbing underslab 057034 -01 360518 -1375 N
Corrections /Comments/ Instructions:
O N i 1 d 1\ Co 4- Ne-i.� Lo
. Z.,► re c Nb
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cra 1 —J Date: / 6 / i'4Z Phone #: (503) 718 -
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: PLM2007 -00342
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/20/2007
Phone: (503) 639 -4171 � ' �
Inspection Requests (24 Hrs.): (503) 639 -4175 - I ..
INSPECTION WORKSHEET FOR DATE: 9/21/2007 TIME: 7:OOAM PAGE: 34
SITE ADDRESS: 11945 SW 70TH AVE CLASS OF WORK:
SUBDIVISION: DARTMOUTH SQUARE LOT #: 030 TYPE OF USE:
PROJECT NAME: DARTMOUTH SQUARE
DESCRIPTION: Building fixtures: Other Fixtures: (3) drinking fountains, 1 ejector pump, (2) hose bibbs, (3) primers,
(1) elevator for sump pump (4) roof drains.
OWNER: PHONE #:
CONTRACTOR: KRUSE PLUMBING, CH PHONE #: 360.573.4337
Inspection Request Scheduled For: Date: 9/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
305 Plumbing underslab 056096 -01 360-518-1375 N
Corrections /Comments / Instructions:
P2 / Se „),- - 7 / 0. S oS eSG e la.. � P� � Sc,. w Pu.,o or
et, � ,.ci ,
CL v1 7 , A...744. i- i rev L0
kkvA r vl MwiA.A `•c_ cL Gi�WL� U Gi V 1✓. 1
r u., ,-Alto S 4 s 7 /a• a OS RS c,
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
V1 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 V‘ i — 1 fit Date: c f l,.1 1 O1 Phone #: (503) 718-