Permit /V- CITY OF TIGARD PLUMBING PERMIT
�� DEVELOPMENT SERVICES PERMIT #: PLM2001 -00435
,L .� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/11/01
SITE ADDRESS: 11992 SW ROYALTY CT 011 PARCEL: 2S115BA -90211
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SFA WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 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: Water heater replacement.
FEES
Owner:
Type By Date Amount Receipt
MARTIN, WAYNE C + JOAN TRUSTEE PRMT BB 9/11/01 $72.50 KING CITY
11992 SW ROYALTY CT #11 5PCT BB 9/11/01 $5.80 KING CITY
KING CITY, OR 97224
Total $78.30
Phone 1:
Contractor:
GEORGE MORLAN PLUMBING
9806 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone 1: 624 -6895 Final Inspection
Reg #: LIC 000027
PLM 26 -60BP
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
/
Issued By �! _ ��� ALT; r Permittee Signature: �i l'
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
O 09/10/2001 10:25 ' 5036393771 CITY OF KING CITY PAGE 02/02
IO'd 1ti101 tp�ooa
10/11/2000 08:52 FAX 5036847297 CITY or risara
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- - Plumbing Permit Application -
• arcaiyo: -1 t o permit no: . wcy -
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Off ' se...br o mism.: Budd g permit ao.:
d1- _'' Address: 13125 SW ball B 97
ciof °eard Phone; (503) 639.417I p ` t'solecvsppl.00.: Expire date: .
- Fax: (503) 598.1960 / am d i Li 1, (� Ducis:tied: 9y: ] Reecipt no.:
. Land use approval' Chao tilt no -: Payment type:
I Vet 01 $ UatnM1c
❑ 1 B 2 family dwctling ea eccrssor/ 0 tt U ndusuial 't, Multi- fiumly Cl Ttnunt impsvveta=
O Ncw oonsetuctiop )4 Additiodalteratioufreplaccmcnt 0 Food service 0 Other. •
JOR SITE I NIFORMLATION �� lt / ILL' SUILDI'LE: (lot apn�i inlurlaatinn u'c ched.list)
Job address: - - .. • - 411 _ J • .!.■!I<iL�i� D _ - . 6" - . - ... , i011:=111122111- I - —
13Id sui • - o.: New I- inii x- • y dwellings only:
8 no.: (induda 1008. for each utility ea =amino)
Tax maplax lot/account no.: SFR (1) bash .
l-at.: Block: Subdivision: SFtt (2) bath _
e'rOjcrct ns;nc: • . • ii ! g SFR (3 bath
Ci /coati - .irmi - rapio zip: • 1� c3 Each additional botbaitchea I=
Desetipdo vo It • i premises: game `: Site tiara:e
l)) a - r (� Catch basin/arca drain -
Esl. deco of oomplelion/Sttspacliov: • ryw
Dells/leach line/crunch drain
Frootin: drain (no. lin. ft.)
' . PLUMBING CONTRACTOR - .ufscduod home u till ti= ME
1:21=11 ilb!itallMirtNI manhoics MI
.Address: R : • t immiorm Rain drffia comtecr r 11111.111111
, Cie : • t ♦ r, � 22: I Sanitary sower (oo, lin. ft.) ���
_.. -_ . -- , - . -. • .- - 3'tarov ewer (mom Iin:.sity _. -.. _ -
-
-CC8 no.: ,2 Plumb. bus. reg. no: , .(D 0 ' in Httaorservzee ea. 1112. t) M
14141 1�ei�e or item: - --
Qtr /morn lit. no.: Absorption valve
Coutracznt's rttivc aignahztc: 0 , 0. 1• _ Bulk claw . err _ �_
Pint uame: Op •A ., .' IMOLS Darc: Baalcwater MIN
CON 1( - 1 ' I'LlISON • JinaiaUlavauay _ r011=0 -
Name • •• Clothes wester M MIN
Dishwashez
fo El
Addrzrs: _ Arinlon,g imtdin(i)
City: Sham: Z1P: bj - ' • sip
111110
Phone: Pax: B- msail: .•• ton tank
O" Nett - Mni MEM
. Floor drains/floor siakrJ lb �r�
Music gala' ): • .. ' AA •�1 ■ Garbage , -. •cal � NOM
mss. 11 c4 s a . S � __�
tY �� t1� , y FrtzQl: In - . toll c .., M IMO
Owner lnstallatiooiresidential mainlenaoce only: The wind Iusmltaaoa Primer(s)
will be mach by mo or the maiacca:mve and repair made by my regular Roof drain (commercial) .. 1111111
employee on the propcsy 1 own es pct ()Rs Chapter 441. Siak(e), hede(s). levs(s)
Ovate; dnmture: _ Datc: - Sum
LN(.L LLtt � 1 .
' . r ..r�aa � ��
Teruel
pl..,,,. - wares doszx ■ — •
• Addre-er, Vista beater O
City: MIIIIII Z P: Othun -
Phone: Fax: B -mail: Total
• S �� Q
'tl� ell dcdoo4wove. jdi
tieue .ff∎eda n ® No
a Fa non,iafoa6a. $aa Thi. =p itgpUctdoo .. fee._..- - .. tirmiznoll
03412 A.bdcsnzCud . .- • clphol if a penult ;sad o6t•W1 . -: Plait rum4 q (E -q `_. Y�) $
Caeca ma .o.m4: , _ 1 1 within MO Jaya after Is la, beta .. i. Satre Intct arga \!■ M -«- S '
• . - E:4 �eeptad u oomplde. . Term, - :....:'......-..._ s
or emeaola: r Does w as : L. icy ,`� . : ,ti^�. ;:
■ _ _ r�kchL'; ° .. • "°'aS6 caayooao
r . U . A .. .i:•7:
- - - • • S I : 9 T WOE! -b0- J35
• CITY OF TIGARD BUILDING INSPECTION DIVISION '
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested / a ( AM PM BLD
Location / j 9 Z l l (9 Suite .# 1l MEC
Contact Person Ph 7 7 PLM Uv / o ( yac
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation // � /` y FPS
Ftg Drain . c °� /`� y u Pie GdY. SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
at Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out 9 , ,
Water Service U(/
Sanitary Sewer
Rai Drains
F ART FAIL
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
•
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA ,,t ��/
Approach /Sidewalk Date 9 / �/ I Inspector / L U-� Ext
Other ���!!!
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.