Permit A - CITY OF TIGARD PLUMBING PERMIT
r . � l DEVELOPMENT SERVICES PERMIT #: PLM2001 -00086
131 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/26/01
SITE ADDRESS: 14865 SW 74TH AVE 270 PARCEL: 2S112AC 01200
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 020 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: UNK FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS:
SINKS: 2 URINALS: GREASE TRAPS: 1
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Plumbing work associated with tenant improvement.
FEES
Owner:
Type By Date Amount Receipt
KNHS DEVELOPMENT CO PRMT CTR 3/26/01 $132.80 27200100000
26262 S MERIDIAN RD PLCK CTR 3/26/01 $33.20 27200100000
AURORA, OR 97002 5PCT CTR 3/26/01 $10.63 27200100000
Phone 1: Total $176.63
Contractor:
CANBY PLUMBING
805 NE 4TH AVE
** CCB EXPIRES 8/2/200 REQUIRED INSPECTIONS
CANBY, OR 97013
Phone 1: 266 -2091 Rough -in Insp
Top -out lnsp
Reg #: LIC 33572
PLM 3 -7PB 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 Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You ay obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
. A Iss d B : , , ` ' v - Permittee Signature: 2 7
\_ Call (50 639 -4175 by 7:00 P.M. for an inspection needed the next business ay
FROM : CANBY PLUMBING INC.96 PHONE NO : 5032662091 Mar. 20 2001 09:37AM P02
ITY OF TIGARD Plumbing Permit Application Plan Check [F
3125 SW HALL BLVD. Commercial and Residential Redd By It
Date Road ft:// IGAI D, OR 91223 Date to P.F. 3
433) 639 -4R 71 Date to DST ,-
Print or Type Permit 0 Atoew- Get, t6
Incomplete or illegible applications will not be accepted Related suva :loot , 43/
Cade
- Name o DevelopmasstlPro]ect - ,.• a ih1
11.60 J
Job -- Suite Lavatory
ar
Address s dtxe�ss , , „ � _ 55 w � " Tub or Tub/Shower G on b - t s
Bld N City/State Zip Shotriior Only Q
4 r 7 r rd 7/ 3 Wal es Closet 11.50 Q
-� 11. 0
Name
Mel dd e ( Urinal bishwotter -' l/ ■ 11.50 t Mailing Address Sutle
Owner , Garbage Disosal
arage p 11.60 Mil
�,:, YL W 1 �" 1 11.60 e
Aldo Zip Ph Laundry Tray _ ,/
,r � g g 11.50
, 1. ��• . .. ( We Machtne/Laundry Tray ���� i u
F loor l reirt 11.60 1 ia
: a ! gloor Sink 2" �'
/ . utte / 3" 11.50
Occupant Malting Addre �f s , y1' 4" 11.60
r to Zip T s r I Water Hester 0 conversion 0 Eke kind i 150 •
, , 1 , r y t , _1> Ga .. re• u a se arate mechanical " . rmit. ��
' dl*1r L Ilil
�.�-- N MFG Horne New.Water Service 32.00 NI
/� Y l' �v J lte " , MFG Home New SBNStorm Sewer 22.00
Contractor mailing Add $ - Hose Bibs - 11.50
t l�� - PhO la Root brains 11.60
prior to 0 co t . i f -pi. a 710 Al 1 %) G''� / Drinking Fountain 11.50 00
f Bit R
Issuance, 0 copy . Oregon , . _ 6 ; t J 16.
of bk goenses are Oregon Co st. Cont. Board Lic.ts Fixtures ..-.- )
ngQutred If � , Other
expired In COT -p (d J,arl f a �-- 6e
-
Nome 35.00 Architect _ Sewer -1st 100'
SuKo Sewer -ear l addltlonal 1110'
or Mailing Address
-----
Water SService -1st 100' 38,00 -
N.
Citylstete Zip Pho Water $ervice each addltlona1 32 '�
Engineer 36.00
Storm 8 Ratn Drain -tat 100' IIIII
Demobs work to be done; 32.00
New 0 Repair 0 Replace with NM kind: Yes 0 No 0 Storm & Rain Drain -each additional o+ a' 25` 32.00 32.00 -`
Residential 0 C,etnmerCtat - Cotsdrlerolel Back How Prevention DevlDevice Residential Batdow PrevenUon Device* 18.00
Add tarsal description of wort 11.60
f h 4 . i Catch Basin
` o /./ 50.
' ,a you capping, moving or replacing any fixtures? � insp. of Existing Plumbing or spedally Requested Re
Yes 0 No 0 Ins .coons oe
Rain Drain. single family dwelling
N A sa, see back of form to Indicate work petformud by 11.50 I( ,
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps � 1 / 5 0 4 [ ry �, h
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL , ,� - t
iicatlon, that the trdormetion Ise ulC or near magma is reel set Wig is -3 r '' ' °'x
thereby OrTC . that 1 that 1 have read this r 6 r r ; „ , t*o : +> i2 �
r or sari ed agent of the ewner, a
*SUBTOTAL. E + la �+v i r t [ J , io
given Is ns submitted t, that I em the owns how b 9 , c . r , ,
tttod Bra to co anon with Ore, on Slate Laws.
that .► b � 8' y. SURCHARGE ° rfl9iat; +7;• .` 1
. rAy No, �� ' , y,� p si - �t� � a,
vi iiii
ci +� 7 e' e . fir a , � **PLAN RtrVl�if x6 OF SUBTOTAL ' y'� } " +� L �• "t /
r,1 t l
total Is ? 9 f 7 y , �/
R • eked P.
f, ��.�+ TO TAL 4 .e;' ,..., i
"ter r' ",rill';-t-3,..i l ,, Rsr: a Let '.
tt r.�I��,+n
1 ` r r ' i 1 ,' i r f i Y, [ (+ r [ l r t , s r •Mtratmtarl Panrttt tee 1s i30 t 5% Wfr harBO, meet Residential Bestow P�evenlia"
.fi , , ia ( , r ; +); ai l , s',.: � - t,1 , 1 `3. 4+, j p„lde,wt Is $25r
f „-,,,2•i. 101; .' 1 S r,t ill..r1- 1 .ril r r '' » M pJew GOmmefai ll aundin8em9uireplane withtonal &erdserdlegwmand
Plan review.
1 tedstafteeellumapp doe lrnOM
/z
C ITY ° OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested s77 AM PM BLD
Location / 7 too s S G✓ 7c/ 4 v_ Suite 2-1 MEC
Contact Person Ph 1 g /D2 PLM AOU / U O 0 no
Contractor — V SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing cess4./ �/ / � p
Foundation 0A1 / � ow t e l j1
Ftg Drain o� J
Crawl Drain Inspection Notes: � �p I %d� / SGN
Slab � I ' / v SIT
Post & Beam 5y) 4 { c -Coyer W ,.
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 1.ifr
Susp'd Ceiling Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Ra', n�
s �rai4
1, PART FAIL
M ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
•
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk 5-- 7 /-0 `I .� � Other Date Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.