Permit A CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2003 -00496
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/22/03
SITE ADDRESS: 11850 SW GREENBURG RD PARCEL: 1S135DD-04300
SUBDIVISION: ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 3 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: 4 OTHER FIXTURES:
TUB /SHOWERS: 3 SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Repipe water system, replace water service line.
FEES
Owner:
Description Date Amount
PATHFINDERS HOMES INC
20055 SW PACIFIC HWY STE 105 [PLUMB] Permit Fee 9/22/03 $320.60
SHERWOOD, OR 97140 [TAX] 8% State Tax 9/22/03 $25.65
Total $346.25
Phone : 503 625 - 9151
Contractor:
3 MOUNTAINS PLUMBING
PO BOX 386
SHERWOOD, OR 97140 REQUIRED INSPECTIONS
Water Line lnsp
Phone : 503
Water Service lnsp
Reg #: LIC 141187 Rough -in Insp
PLM 34 - 368PB 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 ____
Is ued By: `� 1 4 / P ermittee Signature:, � /l1 , ,i 41�4.;��
� _ v
Call (50 639 -4175 by 7:00 P.M. for an inspection needed the next business day
f 09/18/2003 10:35 5039259104 3 MOUNTAINS PLUMBING PAGE 01
7 ,
09/17/2003 16:06 FAX 6035981880 CITY OF TIGARD e1002
Building Fixtures •
Plumbing Permit Application
City of Tigard Planning Appvoval Saver
Da4N8y: PannitNo.:
13125 SW Hall Blvd Piro Rte+ OelCa
Tigard, Oregon 97223 Date Tevinr uma t
Phone: 503..639 -4171 Fax: 503 - 598 - 1960 Use
Internet: www.ci.tigard. cc.= ■ 4. .I I . C
24 Sour Inspection. Roved: 503 - 639 -417 3 • T . i - Y - - - - ^ ---,
■ New construction lilt Demolition . ► ,
p itlon/altetati Iecemen Other: . I Add ' , , .. t � - - �' _ •
1 11 1 & ?pFamil }' dwe / _ Ccu►1/lndustrial SFILO bath '24. 0
SFR ?bail 33U� -00
IN • Ices •, Buildi . _ t .. .. . , Fami (3) 399.00 •
I Master Builder is Other. 1?oels aMittotaesl b hen 45.09
. ..
�. Firo or - ' - ,
,rob site 8<�BCCSS: r 0 S � i - ..' ._.�_ _ - _ . ,
Suite #: Bid . tit: Z catch basi:Ants drain 16.60 MN 1l III I
Pr • act Name: i . A 1.. , r 01 ° - MEM Il t�rywslUkacb Um/trench dzaim 16.60 2
Footing cinths (no. h eeet it.)
&ol:a street/Diree : ons to job site beisimfactured hotrod utilities 110,00
(,- l. e •t. — P ' i C. t VSJ -- / 1 uw Manholes • 16.60
Reim drain eormactor 16.60 -
scwer no. Weer $1, iii.739111.0i ill
Subdivision. I Lot #: I. M I
Tax roa L. arccel *
Abeorp2toa valve 16:60 II r i / Baaktltsw pasventer Pan 2
,. , „2 Bar valve _ 16.60
1111.ffiraillilliM Clothes washer _ 16.60
Dietwasher 16.60
Drinking 1ba 16.60
•
_... 1 i.. ........ .10. 1660
/� � ame: N1 • . •;11 . , . I . f
Address: Fiittureosewer oap _ 16.60
II
City/State/Zip: hoar dte ti/0aor sink/huh 16.60
di NMI 16.60 NM e
Mac 1s t MI INN
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.1 i • : - ._._.._,_ .. der .6s RIM II
eme: • a .. , _ a ,..G ... 16.60 MIMI III
Address: a d s ,. a C M e ll... value: $ _ R MI
City/State/Zip: J L, n r t? / 'J °1? I Li 1 � 16,60
r� Roof de is (commercial) • 16.60
Phone: 3 n - o Fax: 6 'L = 9 i 5 3 Sink b 16.60 III I
'E- nail: Tablehawe lahowar. p ;„I
16.60 ;„IM _%3
IYMINIIIIIIIMININIMMINIMMINIII 16.60 11111111
_.._.. wader aloe ! i8so ' ' -
thisi ass Name: __ r �n . •+ , un� a star Beater 6.60 En a
Address: 0 f. 4. ,. Oilier 'airriMITEIMIIIIIIIIIVIIIIIIIIIITNEINPril U
CI /State/Zi.: "-tv • re 0 e 0 Other - - . iii
Puns: el zr 11 4 z Jaye: 1'2 Y 1 10 t/ .
CCU Lid- #: (N i ; ”! Plumb. Lic. #: - tY ' Subtotal $12 0 $ 3 • _
Man Permit Pas 57'2.60 S
Authorized Reeid�tial Reekfiow Minimsno Pee S36.25 •
Signature: F r. Dam 7 - jit' 0 ) Plan R evkw (25% of rtera�t Pee —
•
1 h l.e aei Slane SttrobaQs (8% of Permit Fa) 5 0 • 4
Nadir= TbM permit applitobap expires If a permit to got °b:.igoa within All MIN esrpniardal bWldiag snubs' 2 •.d of pima .r3& tleillatrile or
le0 d.)s saw it Las been eoeepted aI complete& rigor dim Tor plan review,
*Pm mmtAodolop oat by'A4•S -(.b my Ilhaildbig I*d wrs 8erifoo .
iAtirteaverreit P iAPlmPernitAppauc 01/03 RF C E vpr,
SEP 18 2003
clry rI�D
BUILDING of DGA
IVISION
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST •
INSPEGTION' DIVISION - Business Line: (503) 639-4171
BUP
Received- 7 Date Requested, AM PM BUP
Location ° 5) ---- Suite MEC
Contact Person __Ce.Z.;i4./
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation
Ftg Drain Access: L) ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam e cea
Shear Anchors
Ext Sheath/Shear C-a 1/
Int Sheath/Shear
Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Other:
Final
ia3111;71 FAIL
Illumb. rew
Post &
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
PART FAIL
M CHANICAL
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
Approach/Sidewalk Date -2 /6 /a y Inspector (zP-7\ Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL