Permit - CITY OF TIGARD PLUMBING PERMIT
4 � DEVELOPMENT SERVICES PERMIT #: PLM2002 -00112
'� v.��i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/8/02
SITE ADDRESS: 15259 SW 98TH AVE PARCEL: 2S111 CA -10400
SUBDIVISION: TAMI PARK ZONING: R -7
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
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: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install 40' water service.
FEES
Owner:
Type By Date Amount Receipt
LITTERMAN, MARK AND KATHY PRMT CTR 4/8/02 $72.50 27200200000
15259 SW 98TH AVE 5PCT CTR 4/8/02 $5.80 27200200000
TIGARD, OR 97224
Total $78.30
Phone 1:
Contractor:
JACK HOWK PLUMBING
1910 NW BURNSIDE
PORTLAND, OR 97030 REQUIRED INSPECTIONS
Phone 1: 235 -8784 Water Line Insp
Reg Water Service Insp
eg #: LIC 146779
PLM 26 -288PB 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 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
i
Issued By: _ L. Permittee Signature: ,5)1 fp.e i ".-
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
1
Plumbing Permit A _ plicati )
tt Date received: 02/ _ Permit no.: F4� -- Co //?/
"�'P i Of TYgard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223 - - -
Cay , d a " d Phone: (503) 639 -4171 Pi ject/appl-no,: _ _ Expire date:
C
Fax (503) 598 -1960 Cl i j( 4'1,1-r-, Date issued: By :� ,1 Receipt no.:
�� Lalyd use approval: 1 B�' 4 Case rile no.: Payment type:
11'1►14; O1 ri Unt1'l'
.. 1& 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family ❑ Tenant improvement
O ew construction CI Addition/alteration/replacement 0 Food service 0 Other:
Jolt SITU. INFOHt'i1 V1 ION FEE S('111.1)1 l.l( (tot spt'cial iulornlutiuu utie cli ckIi,t)
Job address: • _ _ ,, Deseri , on Qty. Fee(ea.) Total
Bldg. no.: Suite no.: New 1 - and 2 -frwily dwellings o y:
Tax map/tax lot/account no.:
(Includes ;oflu for eachutllityconnection)
SFR (1) bath
Lot_ Block: Subdivision: SFR (2) bath M ��
Project name: /r10.4", - '/r S (3) •ath
MN
City /county: ire We' ` Each addition: bath/kitchen -
Description and le i Lion of work on premis - .: • Site utilities:
, ./ Ar_._ _._° „ ,i / Catch basin/area drain
Est. date of completion/iaspectlon: Dryw s/leach line/trench drain
11.1 n7Ii1N( CON I R.1C'i'Ol( Footi' :. drain (no. lin. ft_) -;1. IMI=IIIIIII
Business name; r . arse? it1 _ tI a _ • = =
Address-
b el, f , e _ y1+7Lr Rain drain connector -
, .� }� ,fit' ga3m Sanitary sewer (no. lin, ft.) — � -
Phone:8 -- r a riZiridEREM mail: Storm sower pa lin, ft.) � �
GCB no.: „„ ' '1r �'R' no :,� /r -4 ,a ram Water service (ne. lin, f .) G ���•s ; r �, v
City/metro lie. no.: 0 i 0 d WM, Fixture or item: -
i,s �
Abso . valve
Contractor's representative signature: w , �.- ,. �••. - � � : ac k flow , re ter v en MI
Print name: ;C ' A)/9-�0 ,A) Date: 'I -; 0- MUM.
('ON I \(`I 1'1 124() \' Basins/lavatory
Name: Clothes washer
Address: Dishwasher
at : State: ZIP: Drinking fountain(s)
Phone: &mail: E i ansi n tan
Fat � ansion tank
Name (print): f • t 11 1Mailing address: arbage ' a •esa arl
H_ ose bl bb w
City: State: ZIP: e maker
Phone: Fax: E - mail: lnterccptor/grease trap -
Owner installation/residential maintenance only: The actual installation primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s , laws(s) MEI ._NM
Owner's signature: -- Date: w
1;N (:I N I! I•. It Tubs/shower /shower . an =EMI
Name rinal ��
ater closet _ NM
Address: Water heater � � EMI
City: I State: J ZIP: Other; 1111111MMIN
• , • . Fax: E -mail: Total MN g
j
Not ill adadictioaa credit card. promo c an jarilldtatiam rot mare in remeilie Minimum fee $ 5" • O
s O , , , _ t - - - N ot i ce: Thi p ermit application Plan review (at %) $
r'\ :. t„ -- : - expires if a permit is not obtained _ r
t ' """ f r. ' ' "' ' within 180 days after it has been STOTAI, barge (89'0) $ _ " !�;
l lli�_I�. ' pins. ,, accepted as complete,
No- Cad]. • ,. geatme moral 440 (1900/COM)
0 .' - 7 g. 3 vU Sal ii,t J
1d 6ba ' ON 00 '8 13dHO I W W& T t' : B aa2 ' 8 ' ZIdH
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
. / BUP
Received Date Requested L 7 / f AM PM BUP
Location c� S J � g /24,. Suite MEC
Contact Person Ph ( ) 7 ? PLM ��' 6C f I a—
Contractor h ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access: / ��
Ftg Drain C ELR
Crawl Drain ''
Slab I f ��ff ection SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
er Servi
ani ary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PART FAIL
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 ❑ Please call for reinspection RE: E Unable to inspect — no access
Fire Supply Line
ADA i / w e -
Approach/Sidewalk Date — Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL