Permit 4 C ITY OF TIGARD PLUMBING PERMIT
4 DEVELOPMENT SERVICES
,L ..� PERMIT #: PLM2003 -00624 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/26/03
SITE ADDRESS: 06650 SW REDWOOD LN 150 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 5 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing tenant improvement: Other fixtures= Primer.
FEES
Owner:
Description Date Amount
PACIFIC REALTY ASSOCIATES [PLUMB] Permit Fee 12/26/03 $149.40
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [PLMPLN] Plan Review 12/26/03 $37.35
[TAX] 8% State Surchari 12/26/03 $11.96.
Phone : Total $198.71
Contractor: •
POWER PLUMBING CO
P 0 BOX 19418
PORTLAND, OR 97280 REQUIRED INSPECTIONS
Phone : 503 Top -out Insp
Final Inspection
Reg #: LIC 52378
PLM 34 -150PB
•
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: 41.-
Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next b % ss day
4 _,�(Lavc,3 _ 00
PlumbingPermit Application .
Daterecei �� f9 o Permit no.: 1 _s AP _ , a ,
,- • ,
�� • - . City Of : Tigard - • - .� � �
Sewer permit no.: Building permit no.:
Add �.w __!
Add 13125 S • Hall Blvd, R . 223 t City ofTigard
:Ph (503) 639 - 4171 •_ Project/ no.: .• date:
Fax (503) 598 - 1960 { ( W Date issued: f t Receipt no.:
• . � P ' �L : Case file no : t � . Payment type:
° Land use approval: r ; V-, �fl
_ .... V
-- - . . : X04'- : tr — : ,; ..:- ; .. • . - Y - (-)N 4 •.1.,,4, ....1. •
i - �• "4 + 1487 lt •tit b J .� • - r�. -^i7. - ^-n . . ..� *t...._.- .
-= 0 - 1 - 8c2 familjr 1welling oi_acces o aiMnercra�fndtistr �. `"f- -'O1Vlulti-familj • 1 T -- . 7 . 7 . . Tenant Improvement - " -
:... 1 ,
O N e w construction :" °_ -:. • . . • 0. A dditionlalteration/replacement f 0 Food service ` 0 Other ` " ''t. i• -
JOB SITE INFORMATION FEE .5(1 lEI)I I.E (for special iuiforiiiatioii use checklist) ,
Job address:- U250 S CO f / • so I I • • - . ti,. Description • Qty. Fee (ea.) Total
Bldg. no.: - . Suite no.:.t •5`(j New 1 -and 2-family dwellings only: .
(Includes 100 ft. far each natty connection)
Tax map/tax lot/account no.: a5/iaD4 — 0 / ■4 0 SFR bath • '; ' _. - - -
Lot: Block: Subdivision: - SFR (2) bath •-• -- : - • . '
Project name. h o Oq 1 CO-Ala/4,- SFR (3) bath
City/cotmty:• 1 L n / l0 Z IP: �1 '1,,3„39 Each additional bath/kitchen
Description and locati o f work on premises: SBe�es .. . - _ .
- Catch basin/area drain . ,
- Est. date of completion/inspection: - . _. _ ._ -. L.1-'4 .. • . - Drywells/leach line/trench drain
Footing drain (no. lin. ft.) .
PEEMB1NG CON•I-RACTOIt Manufactured home utilities •
Business name: / i1 j� .4. .tl.� -AM Manholes
Address• /3 j3 m6 /G/ t f / . Rain drain connector
City: E�-f - • 'State: ()Y• I ZIP: q 7,) Sanitary sewer (no. lin. ft.)
Phone: J —t CPC Fax;zV V- ki2.51 E-mail:. . Storm sewer (no. lin. ft.)
CCB no.: 3 7Sf !Plumb. bus. reg. no:72/-1 . SJpe, Water service (no. lin. ft.)
City/metro lic. no.: / 4 b .. .1Fb[tm� o Ileac .
Contractor's representative signature: :. i e , Absorption valve
" ' Back flow . venter
Print name: _ •/$ /NL ,, -)wv ,1-A Date :1i - 41-- . Backwater valve - _ - •
- CONTACT PERSON Basins/lavatory .• . • . .. .
Name T - -- - I Clothes washer
Dishwasher
Address: . , f/ . ! ,f/ >v�/,A %•�I' Drinking fotmtain(s)
City: /oy i / State: eV ZIP: q -7.223 Ejectors/sump •
Phone: 2 — 006 Fax:2 W45 E -mail: Expansion tank .
ON%NI:l( ..:.ercap
Name (print):
. 4 Floor I I. • , : oor sinks/hub 9,H I
Mailing address: Hose bibb
City: - - . ;State: 1 ZIP: Ice maker .
Phone: - ' 'Fax: 1E-mail: • Intereeptodgrease trap
Owner installation/residential maintenance only: The actual installation Primer(s) . ..�_ . . f 00
will be made by me or th m ai n te n an c e an d repairiiiade by my regular • (commercial)
employee on the pro-Pe-hi ty I as per ORS Chapter 447. . Sink(s) basin(s), lays(s) K •
Tubs/showedshower pan - • -
Name: . - - Water closet
Address: Water heater ...'=.,:.. . -
City: 'State: 'ZIP: Other. •
Phone: 'Fax: 1E-mail: ToW 3° jj / •
Not all jaxi edom accept credit cards, please call jtciedictim for more ioformatioa Notice: This permit application Minimum fee $ I LO • 0 •
O Visa 0 MasterCard Plan review (at _ 96)' $ 3'1. '15
expires if a permit is not obtained State surcharge 896 i i : cc 6,
Credit card number: / / � ( ) • • $
.. Expires within 180 days after it has been TOT $ I q Y , '7 I
Name of cardholder as shown on credit card accepted as complete. • .
S . • ,. - •
Cardbolder tlVisuae Amount - • 440.4616 (60M'OM)
-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received YS Date Requests. ! 40, AM P/M. BUP
Location C(�v� 'a Suite l v l5 MEC
Contact Person Ph (5 2446 / f ) 4 -924
Contractor /.L1 ) SWR
BUILDING Tenant/Owner - ' - ELC
Footing
ELC
Foundation
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
P•— _``T FAIL
P• - "c
Under Sla
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
•I
PART FAIL
• NICAL
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 0 Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line /'
ADA Approach/Sidewalk Da t e � / c0 /o Inspector �� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL