Permit A D1TY OF TIGARD PLUMBING PERMIT
r a DEVELOPMENT SERVICES PERMIT #:.PLM2000 -00381
'�I II 13125 SW Hall B lvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/16/00
SITE ADDRESS: 16015 SW ROYALTY PKWY PARCEL: 2S110CC -04000
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 014 JURISDICTION: KIN
CLASS OF WORK: OTR 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: 1 URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace kitchen sink, lay sink, shower and water closet.
FEES .
Owner:
Type By Date Amount Receipt
CLARENCE LAUTEN PRMT DEB 10/16/00 $72.50 KING CITY
16015 SW ROYALTY PARKWAY SPOT DEB 10/16/00 $5.80 KING CITY
KING CITY, OR 97224
Total $78.30
Phone 1: 503 - 330 -0128
•
•
Contractor: -
KENNEDY PLUMBING '
13985 SW FARMINGTON RD
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Phone 1: 643 -5535 Rough -in Insp
Reg #: LIC 001009 (CORRECT #10967) Top -out Insp
PLM 34 -42P6 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 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.
Issue y : .` i ,� �L( ,-# - Permittee Signature: /j,� , / / _, /, __i',
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next busin - ss day
OCT - 12 - 00 THU 02:10 PM City of King City FAX:503 639 3771 PAGE 2 I
TRt {OUNTY .
SERVICEfuNTER Plumbing Permit Application OFFICE USE ONLY .. .
- - `� City oP King City • Date received; 0 - WOO. Permitno. N 900 0 -oO 3 :r r
.- �" a S ewer p erm it no,: Building p no
w 13123 SW Hall Blvd.
T Tigard OR 97223 • Project/mil. no.: Expire date:
Clackamas Phone; (503) 639 -4171, FAX: (503) 684 -7297 ��1 t .
Multnomah ` � ssu
( Date ied: E
Washington �
c o u N r r e s Land use approval: �.. Case file ne.; Payment type: •
TYPE OF PER'IIT
- Eel & 2 family dwelling or accessory O commercial/industrial i] Multi- family O Tenant improvement
O New construction 0 Addition/alteration/replacement D Food service 0 Other:
JOB SITE LLFORP1--NTION FEE . SCHEDULE (tor special information use checklist)
• Description Qt . Fee (ea.) Total
B l d seedless: 1(30 1 510 (1 ' j S �-� rv I and t farpily dwelling) only'
Si d g . no.: Sw no.:
-- - • (iodides 100 for each utWtymaoaton)
Tax map/tar lot/account no.: SFR (1) bath •
Lot: Block: Subdivision: 11R (2) bath
Project name: c to (4 t1C e, 0,,,LAJ-.e n SFR (3) bath - -
City /count: (Li or.J. ��2CP: °I 1 'A 'a Lk Each additional bath/kitchen ,
'
Description and location o l pre ryes — Site utilities:
t(� f 1 a�.(. ( , 1G.(5 \ % YNQt ! , Catch basin/area drain - --
Fst. date of completi0n(ir pection: r\ Eli- . . Drywells/leach linc/vench drain
PLU:� G CONTHACT Fonda: drain (no. - link ft.)
11-0 Manufactured home utilities
- Business name: rw\op., 'tut O t(�� a oes M �,
A ddress: 13`1R5 S_ '' corms n' fo e Rain drain c«meaor `� "
City7 Cli i 40( l ZIP. 1 0° 5 Sanitary sewer (no. link ft.) -~
Phone_ (,4`3� 5 Fax: E -mail: Starr! sewer (nee, lin. ft)
CCB no.: 109 6 - � Plumb. b_ — us. red no: _ i - 2 't Water service (na. lin_ fe) _ -
, . ... .. ... ,_.......- -. - realist or hens:
City /metro lie, no.: I T3
Contractor's re resenta1lve signature ` Absorption valve
h e0 t SS to: 10,1at.O0 Back flow p -
Rim name: Backwater valve c - . --
CO\ PERSON - Basins/lavatory
Name:
„,...• h e ((� 4 SS Clothes washer
Dishwasher
Address: 1 R 85 Sul 'CO rrt,inc fd ( ---.- ),-- ain(s) '
City: e S taeo ZIP: c 7 00 5 --ectora/sump ., Phone: , 3. 553 Fax E -mail: Expan
^ s tank
01WNCR . Fixture/scwer Lap - --~
Name (print): C kCt(Q r,C,�, ! Ulj..t, Q (1 -. Floor insrtloor sinlcs�/ tub
�lai)in address: 16015 5u? a o G Q• 0� a ge
-: Hos bibb
City: FA (�q Lt r _ Sfate:p 7 `l as _ Ice maker
Phone: 3 '5 O t ) n: �_ j lrmaiL 1W-raptor/grease (rap ____
t�
Owner ins llatimtlresidential maintenance only: The actual installation Prtmer(s) — I .
will be made Dy me a the maintenance and repair made by my regular woof drain (commercial)
employee an the proprsty I own as per ORS Chapter 447. $$ k(s), bosin(s), lays(s) a. ' 3
Owner signature: Date: , Sump
'
ENGINEER Tubs/shower /s wee pan _ 1 _ _ t h.
Urinal __
Natne: . `Water closet .v I - b!�
Address: "niter heater
City: • -- State: ZIP: ()ire r -
Phone: i Fax- E -mail Weal - -
rNp, .U occ∎ol sad +tank. .tact mud lade,. few own lntnh1let Minimum ice $
y Odom r soda: i o e►pu aPpGcadon Plan review (at - 40) $
J visa ct M stotard expires i e penman Aor Mane. yam
Cr cord number: _ _ - -_ -• P witin SO days after v has been TALehar (8%) $ - .5 •
pi..pi..., .., o, .rdltnrder ae me,+ a o l neon ca accepted of or
eAPtere.
I I - cameot.rtr tipararc ------ - -- $ Min iD41616 lAWCfMI
1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /1 — y AM PM BLD
Location / .54.J go 7J p /i'w y Suite MEC
Contact Person Ph 313 - 4V 3 3s'3j PLM ?e -e / Y (
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
UMBI
' Pos Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain ' rains
• 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
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
Approach /Sidewalk Date Inspector 4 ® Ext
Other
Final
PASS PART FAIL DO NOT EMOVE this inspection record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
244lour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /0-11 AM PM BLD
Location /6 D / S 5L tU l ui l P/6w 7 Suite MEC
Contact Person I / Ph o[i/ 5T3 PLM , w - `" 3 -1
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
I?ASS PART FAIL
PLUM_BIN
Post & Beam
Under Slab
o u
ater Service
Sanitary Sewer
Rain Drains
Fin -
PART FAIL
ECHANICAL
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 [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk nn 7/ Other Date l In spector Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.