Permit CITY TrGARD PLUMBING PERMIT
I DEVELOPMENT SERVICES PERMIT #: PLM2003 -00071
A11 DATE ISSUED: 2/28/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 08323 SW LANGTREE ST PARCEL: 2S112CC 10700
SUBDIVISION: LANGTREE ESTATES ZONING: R -12
BLOCK: LOT: 039 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: 35 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water service.
FEES
Owner:
Description Date Amount
MIKE CHACON
8323 SW LANGTREE [PLUMB] Permit Fee 2/28/03 $72.50
TIGARD, OR 97224 [TAX] 8% State Tax 2/28/03 $5.80
Total $78.30
Phone : 503 639 - 6378
Contractor:
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030 • REQUIRED INSPECTIONS
Water Line Insp
Phone : 667 1781
Final Inspection
Reg #: LIC 23847
PLM 26 -208PB
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
Issued By: /' Permittee Signature: li-A/ /`,/
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
P lumbing P ermitA pplication OFFICE USE ()NIA' -
Date received: ZAZ4,o,3 Permit' naltM Zo_ o3 Do o 71
, � - I City of Tigard > � � D permit g permit no.:
�J g Sewer snit oo.: Building
Address: 13135 SW Ball vd, ig 7
City of Tigard Phone: (503) 6394171 r/ jecr/appl. no.: Expire date:
Fax: (503) 598 -1960 FEB 28 200 'fl, l6 Date issued: ByReceipt no.:
Land use approval: CITY nF T1CAR Case file no.: Payment type:
TYPE OF PERMIT
& 2 family dwelling or accessory 0 Commercialfiirdustrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/rcplacement 0 Food service 0 Other.
JOB SITE INFORM ATIO N FEE SCHEDULE. (for special information use checklist) '
Job address: 032.3 $fr v 6 /1 Description Qty. Fee( ea.) Total
Bldg. no.: Suite no.: - >q ew 1 - and 2- family dwellings only;
(iadude s 100 ft. for each utility connection)
Tax maphax lot/account no -: SFR (1) bath
Lot: Block; Subdivision: ,r j ► SFR (2) bath
Project name; / . (/ 9/\./ SFR (3) bath
City/county: j .1,6,1: ZIP: 2._# Each additional bath/kitchen
Description '/ kti or o . •- _ _ - Site utilities
'' , w - _ - p . /. v Catch basin/area drain
Est. date of completion/inspection: - 2Y .0-0 Dry wells/leach line/trench drain
PLUM BING CONTRACTOR Footing drain (no.lin_ft :)
� ��v Manufactured borne utilities --
t:= f � — � // �.Ar � / e .M i l a� 1,•( 0A i Manholes
Address: Ivh� L� f! 2- Rain drain connector
111: 'T Stat ; - • 411 zl'4071 f►i� Sanitary sewer (no. lin. ft.)
liZ ;. aim s Storm sewer (no. lin. ft.)
no.: � V Plumb. bus. ��� ;� � � ` Water service (no. lin. ft.) lagAlligEj
City/metro lie. no.: 1: ' tare or item:
`.- �� r : ,so •lion valve ,
Contractor's representative signature: 111! 1A4(. _ ack flow prevcnte:r —
Print name: 409 lei � 1 '1 `f list Backwater
C _,-_T P_-- -:r.N 1117 ;story
I Name: M'/ er o other ashen
I Address: "got 3 [,Ft�/GjIL6�' Sr ,,= , r
ountain(s)
` City: % G�.6 Sta �Ir 't � �'4` wow.
' Phone: <03 9' - 3 71 A is , � I
W NE'. .ers+= wet cap
Name • rint): im,w Floor drains/floor sinks hub IIIIIIIIIIII
is irium � Garbs =e
Marlin addres
MU , IFIS , U P: - ' ee maker
Phone: • Fak, ., - E- mail: -" Interceptor /grease trap
• Owner i .n/resi tied maint- A co only: u ..T installation Primer(s) _
will be m.. me or c maintenance . e 'A" made by my regular Roof drain commercial)
employee on the property I own ';+' Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: _ - --- Date: Sump
EN GIN EER Tubs /shower /shower pan
Urinal
Name: _ -- Water closet .
Address: Water heater
City: Other: r
Phone: Fax: Total
r �. Minimum fcc $ ,-- 7..g e t
Not ail jurisd vi m< iCtiors accept credit Ennis. v< call jurisdiction fur MOM information. N This permit application
El visa ID MasurCare expires if a permit is not obtained Plan review at
%) S
I 'i wit State surcharge (S %) - - -. $ IWO
Credit card number: �A ' , r in 180 days Etter it has
/>%r'T7d. ii a i =� opted as complete. TOTAL _ - $ —
Name �. 1 7,1ir• re•tF? ,
0
ardboidcr sigNau Amount .1616 WOO /COM)
- F; : f5 --- WeA 1
0 - to *0.'3-- ,e26/---2e43
1d 6017'0H 9NIEWfl1d >IMOH >10lcJf -- I.Jd9C : 21 —20E12 ' 82 ' H3A -- - '—
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION 4 Business Line: (503) 639 -4171 MST
BUP
Received Date Re nested AM PM BUP
Location g 3 2 3 Suite MEC
Contact Person Ph ( ) 235- PLM 3 - o o a 7 l
Contractor � " Ph ( ) SWR
BUILDING Tenant/Owner _ 4 't ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT .
Post & Beam
Shear Anchors
Ext Sheath/Shear ' 3 • 3 D F
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
Rou h -I
ater ServvjcP
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
F -
PART FAIL
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 ---
ADAj
Approach/Sidewalk Date ✓ l Inspector � Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL