Permit CITY OF TIGARD PLUMBING PERMIT
PERMIT #: PLM2003 -00051
���� DEVELOPMENT SERVICES DATE ISSUED: 2/20/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13727 SW PACIFIC HY 150 PARCEL: 2S103DD -00400
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SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 2 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES: 0
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: A
FEES
Owner:
Description Date Amount
CB RICHARD ELLIS
PROPERTY MANAGER [PLUMB] Permit Fee 2/19/03 $149.40
1300 SW FIFTH STE 2600 [TAX] 8% State Tax 2/19/03 $11.96
PORTLAND, OR 97201 Total $161.36
Phone : 503 221 - 4810
Contractor:
HIGHLAND PLUMBING
PO BOX 1866
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone : 503 Rough -in Insp
Top -out Insp
Reg #: LIC 145756 Final Inspection
PLM 3 -479PB
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
1 '
Is ued By: ;�1 _ 1 ����� ' Permittee Signature: 34,01 . N iV
•
Call (503) 639 175 by 7:00 P.M. for an inspection needed the next business day
Feb 10 03 10:48a Douglass Shinn 5037222274 p.1
- -• ..• 1L _ao CAA au4aurttuau CITY OF TIGARD
001
BUP2t005 - 000.1 Swea-00 S - 0 00 6 ,
Of Tigard Permit• lieation-
�' Tigard Digerati M g 1023 pennitno.: pL idao - ct..05 / 'R
4 I! � dd�eas: 131?S Hall l Blvd. EC G I V E D Se ve rn_: : > tno�
C � c ° T l ard Phone: (503) 639 -4171 Proja✓appl.no.: Expired= Ql
Fox: (503) 548 -1960 FEB 10 2003 - Date island: • Bri;46 1 n o.: .
Land use approval: CITY OF TIGARD Ca "�` no.: - P° "tt :
0 1 & 2 family dwelling or CosamrreiaUadusuia) 0 Multi-family 0 Tenant improvement
D New construction 0 AdditionAthecatioalreplacemem 0 Food service 0 Other.
.1 013 SITE INFORM.; 110N FEE .Sr 11E DU . I (for <hecial inronration a <c ehrckliss) E
Job address i 1 for .i t- n ,-- • i .1 - .. , . Famous. Total - .... --41—,-- Bldg. no I Smite no.: / 5D ass 1- and E ou only: •
Tax map/tax lot /account no.: ( Ioctrades lee R [oresdlgWHy000ueet>de)
SFR(1)bath
t :::: '
Lot: . [Block: !Subdivision: SFR (2) bath
Project Herat: "---L--)t_....--A. r�r` SER (3) bath )� ddi
• Each additional bath/kitchen
Description and location of work on p MentYdiea
• Catch basin/area drain
Est. date of completion/inspection: ". Drywalls/leach liar/trench drain —
PLL� :MBIN`GCONTRA(1 " "' dtainGw- .lia'fl) _
"■
Business name- g (--, h 1 r I 0 tM J l•t—le, Manholes Addres s _ •
. �` J_ �.,. i• ', !� � Rain drain connector • ----� �
City(') _p /'ir- em ( _1- .5 Sort 4'' ZIP:5' ,ti,'.! 1 • Sanitary sewer (110 lie R.) ,
Phone: - 3- L. I. ILI ax ;r — /.j1E -mail: - . - . Storm sewer (no. lin. ft.) ,
t:11-194 b a CCB no.: / 4575. PIumb. reg. no g p ' ' Ater service (ha fin. ft.) • Ant
I City/metro lira. no.: c M2• -1 i Ayr - Fixtnreorltem: •
• Contractor's ce
s reptestative•si . • , ' Absorption valve -
• -Back flow pa:venter . 1 1
Print name. .f_ . _.- as■ r" Backwater valve
(OT % . C T I' I fl O (N ,Basms/lavatpry . •
Name: Modus washer
Address: Dishwasher
Drinking fonmala'(s) -
Sta 21p -- t - ore/sump _ .
Phone: Fax: E-mail: • • •
o«',\ I.0
Name (print): • Floor • ' , �+ .r.. !!;,., . i►
City: lblailittg address: State: (ZIP: Hose H. k - r� - Ice maker / Phone :. 1Fax: I E- urail: ' r •�
Owner installetion/raddentiel maintenance only The actual installation ` Priarcr(s) Q / rd''N/ C3 oPf • will be made by me or the maintenance and repair made by my regular Roof drain (eotnmereiat) , / / 44 r AI
employee on the property Iowa as per ORS Chapter447: • Sinlr(a)..basin(s). lava(s) t c XF /
Owner's signature: Date: Sump
IIIIIIIIIIIIIMEMOMIIIIIIMIMMbsistaswedsh°wer Pall ,
Name: Urinal . '
Address: Wattr.ciaaet .. i , .
Water heater I
city; . I Stan• I rip Other -
` Phone: j Fax: I E -mail: , Total
'Not on � scene �Ir pleats raai .tom far rasa .;� 1Vlinuttum Fee s / 49. 40 o Vas. 0 MasterCard Notice FhCs perm applicuiaa Plan review (at 96) 5
orpirea if a permit is not obtained
Creak cane mambas: Li . . within. tBO. alter it has ban . State surcharge (8%) .._ S / / -9 (,-, -
- ..
Nam of oraOoWcr a Maas ea ereaa Odd seamed a: complete.
TOTAL ......................S • /4 /.:3(n
S 4 // .
Cardholder siestas= /1� -
/ ✓ au) p � ! � � . i 76 <6�OdCCM1
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to ./\ Qpiev'.