Permit CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2001 -00405
" II- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/30/01
SITE ADDRESS: 10978 SW SPRINGWOOD DR PARCEL: 1S134A6 -00100
SUBDIVISION: ENGLEWOOD TERRACE ZONING: R -12
BLOCK: LOT: 090 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 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
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DISHWASHERS: RAIN DRAIN: ft
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Remarks: Water Heater installation.
FEES
Owner:
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Type By Date Amount Receipt
HARRINGTON, THOMAS E PRMT CTR 8/30/01 $72.50 27200100000
105 FREMONT AVE, STE B 5PCT CTR 8/30/01 $5.80 27200100000
ALTOS,
LOS ALTOS, CA 94022
Total $78.30
Phone 1:
Contractor:
STAN THE HOT WATER MAN
PO BOX 33157
PORTLAND, OR 97292 REQUIRED INSPECTIONS
Phone 1: 503 - 760 -2992 Final Inspection
Reg #: LIC 130755
PLM 26 -632PB
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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: 44i4e4/1;e„2 Permittee Signature: 'Y) ezp
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
08/29/2001 14:18 7610159 STAN THE HOTWATER MM PAGE 01
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Plumbing Permit Application
y,
Data received: sol / Permit no.:P I Av/ 49 #D
r : ' � City of Tigard be&
Address; 13125 SW Hall Blvd, Tigard, O 23 Sewer permit no,: Building permit no.:
Cuy ofTigord Phone: (503) 6394171 Ptoject/appl. no.: Expire date:
Fax: (503) 598 -1960 r Date issued:
7 )S/'• •
( u e sT L /,✓e 6 39 -5// zs D By://5 [Receiptno.:
I.atf use approval: case file no.: Payment type:
•
O 1 & 2 family dwelling or accessory Commercial/industrial O Multi - family CI Tenant improvement
CI New construction CI Addition/alteration/replacement O Food service O Other:
JOlt SI I F INt.tittrl A I ION 11.11 5l'111:1)1'I.1: Our SIlccial illl4Mhlatiu,, ua• d iet:Mkt )
Job address: jf 78 S (,r.) 1z . /N6 -woo b D2 Description r . Fee ea. Total
Bldg. no.: 1Suite no.: '1 OC1_22 New 1- and 2- family dwellings only:
Tax mapitax lot/account no.:
(includes 100 R. for each utility connection)
SFR (1) bath
Lot: [Block: [Subdivision: SFR (2) bath _ i
Project name; EAJG /e coo p r /2 Q A C SFR (3) bath
City /county; , 6-A /2 D ZIP: q-) 2.2. -A / . h addido bath/kitchen
Description and location of work on premises: £rIA 1 A. h -
eA 4 Sheutlllties:
_Iii! 7)4 -L.'9 r i o A. , Catch basin/area drain
Est. date of completion/inspection: - V-O / Drywell each line/treneh drain
Footin drain (no. lin. ft.)
B name: STAN THE HOTWATER MAN
Manufactured home utilities
„Aip,...
Manholes -
Address: P.O. Box 33157 Rain drain connector '
City: • ore and State: Or. ZIP:97292 Sanitary sewer (no. lin. R)
Phone: 760 -2992 [Fax: 76 1 -0 1591E - mail: - Storm sewer (no. lie. ft.) '
CCB no.: 130755 [Plumb. bus. leg. no: 26 -632PB t Water service no. lin. ft.
City/metro lie. no.: 5670 Ab Absorption valve
' "` Back flow preventer
Print name: A id S -04'4- Date: - r Backwater valve •
Basins/laveto -
Name: R 0 IV - f 11 &a - Gil 3- 3‘41-0 7 Clo washer
f
Address;
Dishwasher
City: State: 'ZIP: Drinking fountain(s)
Phone; Fax: B mail: Ejectors/sump t
Fa - 'on tank '
Fixture/sewer c
Name (print): Floor drains/floor sinks/hub
Medial address: Garbage disposal
City: 1 State: 'ZIP: Hose bibb
Ice maker
Phone: ]Fax: 1E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature : .. Date- Sum
Tubs/shower /shower an
Name:
. Urinal . —• •
Address:
star heate�
City: State: ZIP: - . .
Phone: Fax: E-mail: Total
N lohdtmoo es& Neale wt i'°i'stl`d°6 far ®. Info oa Notice: This permit application Minirnum (cc
$ "jam• p�
WV=
t�edu sad MasterCard 888' 3� -�//3 - �1q/y� / /� Plan review (at %) $ S. expi if s permit is not obtained
// .; L , within 180 days after it bas been
State surcharge (8%) .... $
N al_.. ' r • ter Wit, m � accepted as complete.
$ - 7� le)
S
Arrow r04616 (61OCOM)
J _
• r CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
D BUP
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Date Requested \ �AM PM BLD
Location /D 97Y GJvDd Di Suite " ' ' 7( MEC
Contact Person ( el- U 4 Ph 3 9/ 1� PLM �M/ /)d S
Contractor U Ph 2 (& 7 5 SWR
BUILDING Tenant/Owner La.i ■: _ re.r'z / 1 14# • ELC
Retaining Wall ELR
Footing Access:
Foundation (-dip � FPS
Ftg Drain �� �/ '�P' SGN
Crawl Drain Ins tion 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
PLUMBING
Post & Beam
Under Slab , y
Top Out -
Water Service
Sanitary Sewer
Drains
PART FAIL
MECHANICAL
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 Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Z/-D Inspector // J (/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.