Permit CITY TIGARD PLUMBING PERMIT
(' a `i4 DEVELOPMENT SERVICES PERMIT #: PLM2002
r ..�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/2/02
SITE ADDRESS: 14660 SW 76TH AVE PARCEL: 2S112BD 00100
SUBDIVISION: TIFFANY COURT APT. 6� ZONING: R -12
BLOCK: LOT: 065 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES: 0
TUB /SHOWERS: 3 SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: ft
DISHWASHERS: 3 RAIN DRAIN: ft
Remarks: Apartment numbers: 75, 79, 83. Replacing (3) dishwashers, (3) sinks, (3)Iays, (3) tubs and (3) water closets.
FEES
Owner:
Type By Date Amount Receipt
BOROS, STEFAN A + FIVIA PRMT CTR 3/6/02 $249.00 27200200000
PO BOX 1890 5PCT CTR 3/6/02 $19.92 27200200000
GRESHAM, OR 97030
Total $268.92
Phone 1:
Contractor:
BOGDAN MIRCEA
13512 SE MARKET STREET
PORTLAND, OR 97233 REQUIRED INSPECTIONS
Insp
Phone 1: 503 - 254 -6932 Rough -in
Reg #: PLM 26 -698PB Final Inspection
SUP 6415JP
LIC 98114
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 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: / - Permittee Signature: G
Call (563) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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• P lumn b in g _ Permit A pp li cation £ .
.4 ,, x , v:..4 s ,, , ., 3 Daterecerved : ' ,'� — • Pemut no r � - `'d 8. $t
t. Ci .. o ; ar d • , , ....
t J ar ': Ti— g ... Sewerpermit no ... - . . . Building permitno >; : . .
Address. 13125 SW Hall Blvd, Tigard, OR 97223 .
CityofTigard Phone: (503) 639_4171 Project/appl.rio.:' Expire date :-
• Fax: (503)598 1 1960 Dateissued: CM Receiptno.: • •
Land use approval: - Case file no.: Payment type:
- '' •f ' - TYPE OF PERMIT a W ` . _` '• ...
0 1 & 2 family dwelling or accessory 0 Commercial/industrial ( Multi- family 0 Tenant improvement
0 New construction oi4.Addition/alteration/replacement 0 Food service 0 Other:
:' ' ' •JB
O ` { _ E�
- FEE special ^ chec ° r.•
'
Job address: / a [ � (,� _ i1'_ 1 Qty. Fee(ea.) Total
Bldg. no.: (1 ( (o( 76 ) 7S 79 y-.� :
uite no.: for each utility connection)
Tax map /tax lot/account no.: bath
Lot: I Block: I Subdivision: bath
Project name: SFR (3) bath
City /county: ( )0t-51 a Y1 I ZIP: 9'7 2). .3 Each additional ' '
Des riptior4 pid location f work o premise , , Site utilities:
.' 0 ri 'IS Azea ..s 5 ) atillAwo..51-9.11 Catch basin/area drain
Est. date of completion/inspection: drain
r y , ' 'PLUIYIBING CONTR ' = :, .. Footing drain (no. lin. ft.)
Business name: a f , , p I ` manholes �
Address: 3 572- 5 ce,✓ w t
City: {-por Pt, Q� l 3 connector (no.
Phone: �,) ax: Email: Z IP: ' '
NM
CCB no. ' Plumb. bus. State : reg. no: � � � ' _ --
City/metro lic.._o.: (j •,(„ o b Fixture or item:
Absorption valve
Contractors representative signature: / , ,e,,._
Back flow , .
Print name: o v-, ate: y o/ a Z
Ell w : r s CONTACT' PERSON a , • Basins/lavatory
•Q �KCI5 Clothes
-Name:-- � D rdi a L'jna
Address: ' r l r l ( i - 0 - . - - - t • • .. ,
City:G vesLa i^ SUv?S • I State: I ZIP: g 70 S •
.Phone: � 3 3• 3 Fax: • E-mail: .. Expansion
�_
Name (print): ,c Pale 30"rOS . ,.
Mailing address: (T(S • - 75,016.- /%q0 - - _ Hose bibb
City: -Garbage
' ' "
y: 6;re A'CA -vin I state: 0 -1 ZIP: 926 3 U "
- Phone:503 - ( - 3 0 '3 I Fax: I E- mail:
Owner installation/residential maintenance only: The actual installation
• will be made by me • ■ ∎ .:'ntenance and repair made by my regular • . •
employee on the p . • ,, r �p Ch •ter 447. O ' r, • ` 9;6.:s Owner's `signature:' 0 '- 1-� / Date: 3 � s IIIII�_ • ENGINEER Tubs/shower /shower pan • . , Ell '. 4
. ,Urinal ... • �
y Water closet - • il r:5 r3J
Address: Water heater-- •.
City: I State: • I ZIP: Other:
Phone: I Fax: I E -mail: ' • . _ , . • : .
`
Notice This
Not all jurisdictions accept c edii cards, please call juri for more intbematioa " pe rmit ap . p e fee - $
.. : • Plan review (at _ %) `$ . ` -.: . '`
OVisa 'Cl MasterCard expires if a perinit.is,not obtained
State
cfeditcara auiober I ' within 180 days after it has been State sttrcharge (8%) :... $
t ' , accepted as complete: , - TOTAL ... $ c
Name of cardholder as shown on credit raid • • - , .
Ca dholder •igushne' • Amount . t 440.4616 (
■
CITY Of TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 ,
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested �1 / ,,� AM PM BUP
Location 1 4 1 1 66 D 7 C, I72' �-- Suite MEC
Contact Person Ph ( ) PLM -2476-2- X
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
C 7s 7 7r Y•
ELR
Crawl Drain
Slab I speration Notes: SIT
Post & Beam •
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation 75 F5
Drywall Nailing /�
Firewall / $ /a// , 1.C/
Fire Sprinkler
Fire Alarm -7` C. , ��S 1�1 �c �— !� /si^ cr� a hoc e dv
Susp'd Ceiling 4 ,/ G Roof � Grp /</ (A -7 .
Other:
Final � ,7 �v..0- fdf
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab •
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole •
Storm Drain r
Shower Pan
Other:
ina '
PART IL
' ANICAL
Post & Beam ,- —
Rough -In —
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA �/
Approach /Sidewalk Date 7 e Inspector / a Eat
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL