Permit CITY TIGARD PLUMBING PERMIT
�; DEVELOPMENT SERVICES PERMIT #: PLM2003 -00466
'`� '- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/4/03
SITE ADDRESS: 11400 SW 95TH AVE PARCEL: 1S135DB-05600
SUBDIVISION: MILLER ZONING: R -4.5
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install backflow preventer.
FEES
Owner:
Description Date Amount
WINTER, STEVE
11400 SW 95TH AVE [PLUMB] Permit Fee 9/4/03 $36.25
PORTLAND, OR 97223 [TAX] 8% State Tax 9/4/03 $2.90
Total $39.15
Phone : 503 612 - 4553
Contractor:
FIRST CALL HEATING & COOLING
1650 NE LOMBARD
PORTLAND, OR 97211 -4798
REQUIRED INSPECTIONS
Phone RP /Backflow Preventer
hone : 503 - 612 - 4553
Final Inspection
Reg #: LIC 102030
PLM 26 -674PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952- 0001 -0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699.
Issued By: w,_, Permittee Signature: (1 C �I� t 7�'(--
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
SEP -03 -2003 WED 09:11 AM FIRST CALL HEATING FAX NO. 503 286 5194 P. 03
0001 /2003 08:2.1 FAX 50351)81960 CITY OF TIGAI(L fa 001.
• . RHHA ring Fixtures
.Ph ijji g Permit & llca Recrivcd
Ff L. klrmitN
ED >��Y f' _ y 031313 PmmilNo -• I -Vh�O3 — pZ�Lf�,(
P latmin oral --
City �f 'Tigard Lhde/B : PPr Sewer
1312' SW' Flan ltasrcl. SEP 0 �'Plua ac t Nee' _
Tiprd, Oregon 9' 3 200 Hagar 1'tssritNe.•
Mono: 503 -639 -4171 Fax: 503- 59$ -196Q E'oat,Rev(ow LmdU °c
intrzvc {: ww�w.t; itigard.ot,us CITY F ,�� ID" Y-..• - Catelro.,
1 -hntrr )rntpeutirlra ke.��uc }t: � O TI .'''' � Coate t !wit • yes rake 1 for -
1 1 �11/J,� ION Nuus04ethod: 7 snpplrytuotitAl lnformatinr.
II �' 4�� w c ,t)ft6irtyliori -- D041,0lition - »eon . ; � . Qty
R dd /re • 1s dement I Other. V
M r & 2 arnt dvur n ' Co rrarjercial/Yt_idhst al 'SEC l) bath as.zo
Ile A.ccetssory Tiailciiylj, I _ Muhl aniil�: 8 (3) bath — � - 399.00
+Masts• ,luitla -rt (3) bexl. 399.00
! - Other _ _ Paoh additional bath/ldtelten ry MN 45.00
_ ti Fro • -, ., ft,: • .rob liif r 8dlires .. ... E. _ .
elf ch basin / arm d
SU1t #,: : _� �Ic3t. #� drain � 16.60
T'Cla'eet l+la7rie _ ___ •._. I) lint/trench ikain _ , 16.60
sob site: -. _- Footing drain ( no. &tow ft.) Pa •. 2
(10 5 t;fr t/I�irucTIor1 t mioufaahucd ltvwc utPiCS 1♦ 110.00
M1411:10110; . �...+ . • , i . 6.60
Ruin drain connector M l a.b0
_. — �__ _ ., • Sank sewer do. linesall. - p.. 2
� Sgbdiiyisiort: ~._ _ Lot #'#: Storm sewer de, linear R• ' p. : - 2
,f. knit / Are& #1: - 1' : e z
_..........111144,./L _12 .,, ' • _&1 s 44n
f. 13acl�o on • revenue valve M1 - 16:60 2 Wil Ill II P
,..^.,- _..,._____.__ "_ ..___._ _ --
)3atkwatcrvalve • 16 -60
Clothes washer 16.60 •
- * W war a Dishwasher 16.60
f • } - • • n fauntain 16.60
1 1; ectorN . �,Ir� td...,,, .� i , ... , _ _.. `. _ ._ . ._..
t 16.60
JEbin utl ion tank • - 16.
Address:
jpfe9 .. : &4J+44'e- Fixture/sewres'o • 16,60
.. Fl oor chain/floor �itfit0te /1J�: [.>*. • � 1 - 3�1- sitslclbtyby " 16,60
'i2C►1]: a ,l , F2: Uarbaosal 16.60
Bose bib WM 16,60
. Joe linker al _ 16.60 _
l.Y txxrl: _.....�__ --. Jn ; :loth. a tt • 16 -60
M A tidcens: Medi , pas - yew.: $ P -, 0 2
Jtdy /i,ittr /- --------- Primer mi. . 16.60
f1r)13t 1+ K Roof dram �co merrcial) 16.60 f
Sink/basiil/tavatoy 16.60
I; mail: ',11fb/shower /shooter,par, _ - 16.60 '
Urinal 16,60
Fn5ine5s Hunt;: , e L'4Atir ._ g woterolossst r _�� M. 16.60
fir M Writer heater _ 16.40
�"�,dtkt`xs ' , r -,,, Other:
P 1 . 1 a x l a „ +�t+"'r �;. 'H _ Fax 1S2 %P IN Mill
_ C'CB I40. F: lei 0 'lumb. Lid.#•: ,w, -67 ' .: subinral 2 . Anita [i cil -- e S & _ 3 ,_ o i Minimum ran* Foe 57
9iJ „aturu: . o o I t - -.. _ Patc• - C7- kesida Fee Permit
,r _ _ Alanlevie�! (2 oJ"PCr FOQ _
_ C , &arc Surchar 8% of 1'crnit Fee 1; � _ .
O ust pririi name) TOTAL PERMIT FFE $ ''�,
N.ideil: 'this poi mat eptsii.:4tio h t.ri,lres if A pev>�it Is ont ohl.lusd ry irhin ,p1 u
t pew to m r cIa1 buildings require; sett orpisaa nilb isomer a or
In days eller it Lac been ari:eeteq us eoLoplete. (/ timer ttlegram for plate revle++-
,l *Foe methodology tot by Tr .Couuy Banding in &We , Service Heard.
i6,1} s4\ l 'mnitFoetitis\YtniretrritAVp.d ^ oc 02/03 \ \ •
\ , .
■
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /0 lP PM BUP
Location 11 95 4v - • Suite MEC
Contact Person e Ph ( ) Co/2 6553 4 s - 004“,
Contractor 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
/3(
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
01 =:
f
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call fo reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA % Approach/Sidewalk Date Cf 6 Inspector U 7c" Ext
Other:
Final DO NOT REMOVE this inspection record from the-14) site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour + • �-'
BUILDING Inspection Lin: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /0 -z AM PM BUP
Location /(/ ()O q5 AV Suite ME —0 6 53
Contact Person `�,,t` \ 017 Ph ( S y ) 2 44 2"' 2 e 2 LM 3- cio 64
Contractor S t • 0 I
Ph ( ) SWR
BUILDING Ten. , l0 ne 60774_ ELC
Footing d _ 1 2 — S
Foundation Access: ELC
Ftg Drain ELR
Crawl D ain
Slab Inspection b(YL. SIT
Post & Beam
7
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing }
Insulation } )A C •) t \ J h ))\)/)4)-'t D r` M01
Drywall Nailing ` \ �J
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 Pan
Other:
Final
PASS EMT FAIL
ECHANICAL
Rough -In
Gas Line
Smoke Dampers
anal
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 El Please call for reinspection RE: / jg Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date/0 � Inspector / / . i /
Other:
Final DO NOT REMOVE this inspection record fr • the jo • ite.
PASS PART FAIL I a? 409
I
Case Activity Listing I012t2003
�� 8:39:05AM
TIDEMARK Case #: PLM2003-00466
COMPUTER SYSTEMS. INC. j ini n q VV11
Assigned Done Updated -
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By
PLMA003 Application received 9/3/2003 None RECD FAX 9/4/2003
BB
PLMA005 Create Permit 9/4/2003 None DONE BB 9/4/2003
BB
PLMA799 Final Inspection None 9/4/2003
BB
PLMA750 RP/Backflow None 9/4/2003
Preventer BB
PLMA050 (F) Issue permit 9/4/2003 None DONE BB 9/4/2003
BB
l
t
C
q
Page 1 of 1 CaseActivity..rpt
BUP - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By 41 Inspection Description Date Passed By
Footing /Setback Underground cover
— Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls _ Electrical rough -in _
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural _ —
Shear walls /anchors ELR - Restricted Ener Permit
Roof nailing
- -4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing J Inspection Description Date Passed By
Suspended ceiling Post/beam mechanical
Gas line
Engineered soils _ Mechanical rough -in _
Welding Lab Final Fire damper
Concrete Lab Final
Bolting Lab Final — Duct work
Structural observation Smoke detector
Fireproofing Lab Final —
Mechanical final
Final inspection
PLM - Plumbing Permit
BUP — Fire Protection System Permit Inspection Description Date Passed By
Al Inspection Description Date Passed By Plumbing underslab
Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in
Sprinkler final Plumbing top -out
RP /backflow preventer pr/z)3/9
— Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
A1 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final D D 4 '
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils - 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts \forms \InspRecordBUP.doc 04/17/01
C ITY OF T I GA RD PLUMBING PERMIT
A °1 DEVELOPMENT SERVICES PERMIT #: PLM2003 -00466
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/4/03
SITE ADDRESS: 11400 SW 95TH AVE
PARCEL: 1S135DB-05600
SUBDIVISION: MILLER ZONING: R -4.5
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install backflow preventer.
FEES
Owner:
Description Date Amount
WINTER, STEVE
11400 SW 95TH AVE [PLUMB] Permit Fee 9/4/03 $36.25
PORTLAND, OR 97223 [TAX] 8% State Tax 9/4/03 $2.90
Total $39.15
Phone : 503 612 - 4553
Contractor:
FIRST CALL HEATING & COOLING
1650 NE LOMBARD
PORTLAND, OR 97211 -4798
REQUIRED INSPECTIONS
Phone : 503 - 612 - 4553 RP /Backflow Preventer
Final Inspection
Reg #: LIC 102030
PLM 26 -674PB
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.
Ts 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
N k it ,
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.
c / x
Issued By: Lit , ' .. Permittee Signature:
F
Call (503) 639-4 75 by 7:00 P.M. for an inspection needed the next business day