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Permit A . CITY OF TIGARD PLUMBING PERMIT 1 1 DEVELOPMENT SERVICES PERMIT #: PLM1999 - 00308 .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/24/1999 SITE ADDRESS: 14225 SW 116TH TERR PARCEL: 2S110BA -08800 SUBDIVISION: EVERGREEN SPRINGS ZONING: R - 4.5 BLOCK: LOT: 013 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: Residential backflow prevention device. FEES Owner: Type By Date Amount Receipt RENAISSANCE CUSTOM HOMES PRMT KJP 09/24/199E $25.00 99- 318601 1672 SW WILLAMETTE FALLS DR SPOT KJP 09/24/199E $1.75 99- 318601 WEST LINN, OR 97068 Total $26.75 Phone 1: 557 - 8000 Contractor: MOODY ENTERPRISE INC PO BOX 98 ESTACADA, OR 97023 REQUIRED INSPECTIONS Phone 1: 631 -2918 RP /Backflow Preventer Reg #: LIC 00005973 Final Inspection PLM 11717 ORIGINAL 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: C7n . ` �_ - I Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day • TY OF TIGARD Plumbing Application Recd By (41-0 ,125 SW HALL BLVD. Commercial and Residential Date Reed 9 ® GARD, OR 97223 Date to P.E. 103) 639 -4171 Date to DST Print or Type Permit s �L/rl/999 o(_-_, 30b Incomplete or illegible applications will not be accepted caned sVVR Name of Development/Project FIXTURES;;(1►ldlvidual) ,t • Job /te �/� *i / ? Sink '} r G? tip .0 4qMj { e r L( Addr ess�� �� ` J Suite 9. / ! 2-2 r S'( / �O •7 ri-4.1 C!G Tub or Tub/Shower Comb. 9.00 Address Street Bldg s I City /State /j Zip p Shower Only 9.00 - rig g u t �/ '/ V /l / 7 2 2,' Water Closet 9.00 ' Nffe 1 /� 9.00 A J' Al c " CG OA 1 er- Dishwasher 9.00 Owner Mailing • • • Suite Garbage Disposal 72, ill ejr! r3 ► , Washing Machine 9.00 /State Zip Phone 9.00 es k i s ,✓✓ 0A c / JO :0 -''OVQ Roar Drain r Name e.00 3' 9.00 Occupant Maili Address Suite Water Heater 4' 9.00 n 9.00 City/State Zip Phone Laundry Room Tray 9.00 Urinal 9.00 Nart� C6 f�� c'� , Other Fixtures (Specify) 9.00 Contractor Malting . ' ' � b a Nit 9.00 Suite ' 0.6. . 9.00 (Prior to issuance City /State / / 1 Phone 9.00 applicant must 4 C`Ida Q/C /023 6 31-27 IS provide ail Oregon 9.00 /Orreg o Collet. Cont. Board Liss p 7 t eo contractors fj J 9.00 license Plumbing 9.00 Lic. s Sewer - 1st 100' information to 30.00 for COT COT Business Tax or Metro U p Date Sewer - each additional 100' database). 25.00 ! 7J 3 �, /J /49 Water Service - 1st 100• Name / St 30.00 Water Service - each additional 200 Architect 100' 25.00 Storm a Rain Drain -1st tar or Mang Address Suite storm & Rain Drain - each additional t 30.00 25.00 Mobile Home Space 25.00 Engineer City/State Zip Phone Comer Back Flow Prevention Device or Anti- 25.00 escnbe wont New P m ollution Device Add n 0 Alteration 0 Repair O Residential Baddfow Prevention Device' be done: Residential rJi' Non - residential 0 15.00 ,dditional description of work My Trap or Waste Not Connected to a Fixture 9.00 Catch Basin 9.00 ��2i /� le 4 8� r / �� Insp. of Existing Plumbing 40.00 ctsting use of f I / Spedan Requested Inspections perm, Adding or property 40.00 Rain Drain, single per/hr family dwelling 30.00 -Dosed use of Grease Traps 4ing or property Ps 9.00 • z you capping . moving or reply any fixtures? QUANTnY TOTAL i, e a^9 Y Yes ❑ No Isometric or riser Q 1 a - 'sz r yes see back of form) ❑ ° 9 rwm re w.ed a Ouanity rod is > 9 x - 'SUBTOTAL ` _ _ ?reby acknowledge that I have read this application, that the information . correct n is corre that I am the owner or authorized agent of the owner. and r, Plans submitted are in compliance with Oregon 5% SURCHARGE of regon State Laws. - �: ^ _ 7 .- l Agent / O 9zo/rr u PLAN REVIEW 25% OF SUBTOTAL ` .Arift.z , / Required Drug if fixture Cry. total is > 9 ntact Person Name TOTAL Phone '• �� (r� V 'Minimum permit fee is S25 + 5% surcharge. except Residential Back CJ /'- 29 /p Prevention Device. which is 515 + 5% surcharge M J ..^ -* °�- .a^ �--�, I:\plmapp.doc 12/96 (dst) r ` CITY OF TIGARD BUILDING INSPECTION DIVISION Msr q9 -00/ SC,o 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 3/p0 AM PM BLD Location ` "I 2-2S I/ 0 Y Suite f ,, MEC /� l Contact Person "rya Ai t S Ph 572 -22 (Cj co Qo 3© b Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: , Foundation ccess: c:Or_e �t FPS Ftg Drain SGN Crawl Drain Inspectio otes: 60, p Y Slab ( / / / �- SIT Post & Beam Yt tf±•f i 1 4I4 - 0 (J !1 - f ck- UW Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fire wall //7/4,;(/ ,'� % CJ =G' ' Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof r Misc: Final PASS PART FAIL Post & Beam Under Slab Top rS Water Service � Sanitary Sewer /�%� Rai Drains ter PART FAIL MECHANICAL 6 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 Other Date Inspector Ext Final PASS PART FAIL • 0 NOT REMOVE this inspection record from the job site.