Permit 1 -gin ./M. f 4, Au-A...AA 6-4r•4)
ITY OF TIGARD PLUMBING PERMIT
i4' DEVELOPMENT SERVICES PERMIT #: PLM2002 -00446
AA ' � I I ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/19/02
SITE ADDRESS: 16640 SW 72ND AVE B -10 PARCEL: 2S113AD -01900
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 5 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Reprint permit to amend fixture count as follows: add (1) sink, (2) lays, (2) toilets, move (1) sink, (1) 2" floor
drain, (1) water heater, (1) eye wash, (1) primer, and cap (3) sinks.
FEES '
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES
15350 SW SEQUOIA PKWY #300 -WMI [PLUMB] Permit Fee 11/19/02 $72.50
PORTLAND, OR 97224 [TAX] 8% State Tax 11/19/02 $5.80
[PLUMB] Permit Fee 11/21/02 $33.20
[TAX] 8% State Tax 11/21/02 $2.66
Phone : [PLUMB] Permit Fee 12/17/02 $116.20
Contractor: [PLMPLN] Plan Review 12/17/02 $29.05
(additional fees not shown here) ,
POWER PLUMBING CO
P 0 BOX 23144 Total $268.71
TIGARD, OR 97281 REQUIRED INSPECTIONS
Phone : 244 1900 Rough -in Insp
Underfloor /Underslab
Reg #: LIC 52378 Top -out Insp
PLM 34 - 150PB Top -out Insp
Final Inspection
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
Issued By. - _ , f ' him, . Permittee Signature: _ A pt
CaII (503) .39-4175 by 7:00 P.M. for an inspection needed the next bus' ss day
DEC 04 2002 3: 32PM HP LASERJET 3200 /� , l/ - 0 1 -/ - p, I
r .. y - .r.� t � r / t � rrti n i � V'-'* Qtr - v a+1, ..:-..'.: ,:-..;.;4., � .
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P�umbirigPer nitApplication
�- ' �,. a: �g i � � ��i� ic+�++�nQ �t..if'fL��' P0,9410 • .I, .., i ��. pf T1 Sewer per mit no.: - Building permit no.: ,
Address: 13125 SW Hall Blvd, Tigard, . Pm�ecdappl.rw : • Expire date:
cisy ofli8ard . Phone: (503) 6394171
• Fax: (503) 598- 1960 .. Date issued: By: £ly 1 Receipt no.:
Land u s e approval: 1&"4 v �r Case file payment type:
"1 OF PERMIT
❑ 1 & 2 family dwelling or accessory - O tn
Comucia>rndastrial l] Multi- family Tenant improvement
0 New construction b' Addition/alteration/replacement 0 Food service O Other:
- JOB SITE INl Ol2'LA'lION FEE SCIlEI)UI E (lorspecial iulo Mimi use c'liecklist)
1 t Total
Job address. I J• ew •
1- , , 2- • , .1 dwellings only:
Bldg - no -: Suite no.: • (includes loo g, for each utilityconnedloa) -
Tax map/tax lot/account no.: SFR (1) bath
Lot . :.. ' Block: • /1 4t +P.'S j Subdivision: • sFR (2) bath . _ •
Project name: Iv 1_ � r L ` SFR (3) bath
City /county: WG / G &4 !w0 li I zIP: 6 17.) - 2 1 4 ' Each additional bath/kitchen
Description and location of work on premises: San es
Catch basin/area drain
completion/inspection: Drywells/leac r linehttendt dram
Est. date of comp - , • • t • drain (no. lin. ft.)
1'L1i111i1: \/: CONTIMCTOR
_ Manufacttued home utilities
Business nam v . e; ' _ 1 Manholes
' jrAIN • : - . dram connector •
�1 ZIP: !R�i � Sanitary sewer (no. lin. $)
Phone: •, rat : ;.� Storm sewer (no. lin. ft.)
Phone: `? yy' / �� Fes' =ILO/ r • , : ' : Water service no. lin. ft
GCB n o . : Sa 3 ?� P l u m b . btu rag. n o : ( (� Or Itenx
City/tnetro lic. no.: / y(,, 2.
• Ab lion valve
Contractor's representative signature: i. , : • iff i venter -
- Print name: . A '� Dam b l R: 1 O Z B : : va lve
CONTACT 1'LItSON B:: t :1 : ...I
Name: a , • /. Di- •
: D 40 ` f) MCI a r .. _fountains) •
C�tY Pt) r t 1 • state: j3ir: ZIP: q `yea 3 E •
Phone: 2 - 5 • Fax:2 .. - ..s Email: Expansion tank
)WN I':1 t Fixture/sewer cap Floor drains /floor sinks/hub / /�o.. 4:-- -
Name (print) i - ► , . ' Garbage disposal
Mailing address: t —T_ Hose bibb
City- !State: 1 ZIP: Ice maker
Phone: j Fax: 1E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primers) I " Y • e
will be gate by me or the maintenance and repair made by my regular Roof drain (commercial) . - p ie
employee on the property I own as per ORS Chapter 447. Sink(s , basin(s), lays(s) • ; =� • s� +�
Owner's signature: Date: - Sump 1
ENGINEER Tubs/shower/shower pan ,
Urinal .
Name: Water closet tr, / ' rte' r
Address: Water heater L' . /L. r1 c /6. °
City: j State: 1 ZIP: Other: � Waal- • /' J . /6-4
Phone:
j Fax: j E-mail: Total % `
Minimum fee S If
.r
all Jucisd�coiaos ecccri cl cants O cala c all 1 10° roc more infarmadoa Notice: This permit application
O lan review (at _ %) $ a
Visa Cl O MasterCard
cre expires if a permit is not obtained _
credit card =albcr its within 180 days after it has been state (84b) .... $
P " �
accepted as comp
Name of cardholder as shown an caedit card $ Cardholder dg to Amount 4444616 (6i )iCOM
i
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / r y AM PM BUP
Location A 7 i, / Suite MEC
Contact Person Ci s --�n1- Ph ( ) 9 y-/900 PLM – 4 a 4
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation
Access' ` _ / /;'_ 1.f 2-4 – – _ –__
Ftg Drain �Q ��-�� ELR
Crawl Drain
Slab Inspection Notes: — ' SIT`J
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 FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pa . .___-
Other: 1 , _
PART FAIL
#
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for r- inspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date • Inspector 4 Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received / / Date Requested '3 AM PM BUP
Location llo 1 ' �fb 7 ? .4 4 Suite MEC
Contact Person Ph ( ) 736 a' PLM 1 7 4 /6
Contractor 1/La/LA, Ph ( ) SWR
BUILDING Tenant/Owner 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 FAIL
PLUMBING O; AtliA11.0`■0
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PASS PART FAIL
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: Unable to inspect — no access
Fire ADASupply Line ` 3
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL