Permit CITY TIGARD PLUMBING PERMIT
"'�', '� "l DEVELOPMENT SERVICES PERMIT #: PLM2003 -00569
44% Ill 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/31/03
SITE ADDRESS: 13452 SW 129TH AVE
PARCEL: 2S 104DA -03300
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 019 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 irrigation backflow preventer.
FEES
Owner:
Description Date Amount
WEINSTEIN, MIKE
13452 SW 129TH [PLUMB] Permit Fee 10/31/03 $36.25
TIGARD, OR 97223 [TAX] 8% State 10/31/03 $2.90
Total $39.15
Phone : 503- 246 -6699
Contractor:
PRO LANDSCAPE INC
3045 SE 61ST CT
HILLSBORO, OR 97123
REQUIRED INSPECTIONS
Phone : 642 -5696 RP /Backflow Preventer
Final Inspection
Reg #: LIC 7013
PLM ALL PHASE & BA(
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: , `/ � L Permittee Signature: 1 pi9 (
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
Oct 29 03 02:58p p 2
•
Plumbing Permit j 4ication OFFICE USE ONLY
Clt of T 1 and 6 ` L ( V t D Date received: f t' ,i/ D , Permit no.:? y —o 5"
"`4 -' J n-v- Sewer permit no.: Building permit no.: /
ress: 13125 SW Hall Blvd, Tiga5d,„0R 97,223)
City o /'Tigard
Phone: (503) 639 -4171 4 ' [i /- IOR Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued:
CITY OF TiGARD By: ft Receipt no.:
Land use approval: BUILDING DIVIsIn�[
Add Case tile no.: r
Payment
type:
MIIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIMEIMIIIIIIIIIIIIIIIMIIIIMI
a 1 & 2 family dwelling or accessory U Commercial /industrial ❑ Multi- family 0 Tenant improvement
0 New construction ❑ Addition /alteration/replacement O Food service 0 Other:
• FEE SCIIE DULL (I'or• special informaiiiln nsechecklist)
Job address: t345 2 _ 5 LJ t2 4 }VP Description Qty. Fee(ea.) Total
Bldg. no.: r Suite no.: New 1- and 2- family dwellings only:
Tax map /tax lot/account no.: (includes 1110 ft for each utility connection)
Lot: Block: [ Subdivision: SFR (1) bath
SFR (2) bath
Project name: WE( N.STE Ii..3 SFR (3) bath
City /county: - 16 0 /WA J ZIP: 22.3 Each additional bath/kitchen
Description and location of work on remises: IN,.'7t4 -LC. P Q R..L JSiteutilities:
0.ek. Cif_ Fc4 : /1-- SV Catch basin/area drain
Est. date of completion inspection: Drywells/leach line /trench drain
Footing drain (no. lin. ft.)
Manufactured home utilities
Business name:
{ L fQSCy4f'E, .1 -t.iC - Manholes
Address: _ S f ' l ST t - Rain drain connector '
\if City: RI LC.S (30(2. 0 I State:0 2_1 ZIP: `74 1 23 Sanitary sewer (no. lin. ft.)
Phone: (.42_--5,6%? 1F'ax: /. -1.‘,2_i E -mail: Storm sewer (no. lin. ft.)
,17 - CCB no.: 0 1 1 Plumb. bus. reg. no: \ 21 :9. Water service (no. ho. ft.)
City /metro lic. no.: 35 41 Fixture or item:
00.
or /, Contractor's representative signature: 44 Absorption valve
Print name: Back flow preventer
_ Backwater valve 2 2-1 `
M_ Diu I+ ate: o �3
��/ CONT:t€1' Pl :RSON Basins/lavatory
�(
Name: Clothes washer
Address: Dishwasher
City: Drinking fountain(s)
i
ty: i State: I ZIP: Ejectors /sump
Phone: Fax: E -mail: Expansion tank
Fixture /sewer cap
Name (print): ( ,Q,G- wAL , Floor drains/floor sinks /hub
disposal
Mailing address: P
Hose bibb
City: State: I ZIP: ' _Ice maker
Phone:ey3 - _ (,,q9 I Fax: I E -mail Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Prime
Garbage arba rs)
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), lays(s)
Owner's signature: Date:. Sump
•
EN( ;IN EE Tubs /shower /shower pan
Name: Urinal
Address: Water closet
Water heater
City: I State: ZIP: ' Other:
Phone: Fax: E -mail: ' Total Z 1.55
Not Fjurisdicrions accept credit cards, please call jurisdiction for more inf°[mation.� Minimum fee $
Notice: This permit application
Plan review (at %) $
a"Visa Q Mas[e:Ca,• a permit expires if rmit is not obtained
Credit . number: Z�S 7 �✓ _I 180 days after it has been surcharge 8% c'
Nvac' Expires
shr g ( ) .. .. $
e ore ` � „ � ^ accepted as complete. TOTAL $ � j e , •.:3
• • k.
Cardh°t Amount 4t0 4616 (6 /Oo COM)
. 15
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
O� •��� BUP
Received / Z Date Requested ( 0\ O� AM PM BUP
��2 l 2-
Location /3 � Su ite MEC
Contact Person Ph ( 5 03) b42
Contractor . — Ph ( ) SWR
i
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
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
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 AA_� J„
i
PART FAIL
ECHANICAL
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: Unable to inspect — no access
Fire Supply Line
ADA J�
Approach /Sidewalk Date Inspector k77,,id Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL