Permit 'CITY OF TIGARD PLUMBING PERMIT
I& DEVELOPMENT SERVICES PERMIT #: PLM2003 -00227
� � J I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/29/03
SITE ADDRESS: 13430 SW VILLAGE GLENN CT PARCEL: 2S102CA -00937
SUBDIVISION: VILLAGE GLENN ZONING: R -4.5
BLOCK: LOT: 037 JURISDICTION: TIG
CLASS OF WORK: ALT 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: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 50 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of 50' of water service and (1) hose bibb.
FEES
Owner:
Description Date Amount
WIRICK, JOHN C AND SUE E
13430 SW VILLAGE GLEN CT [PLUMB] Permit Fee 5/29/03 $72.50
TIGARD, OR 97223 [TAX] 8% State Tax 5/29/03 $5.80
Total $78.30
Phone :
Contractor:
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Water Line Insp
Phone : 667
Final Inspection •
Reg #: LIC 23847
PLM 26 -208PB
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
AD
Issued 8ei - - Permittee Signature: A-
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
r.
Plumbing Permit Application '
Date
• l : a' 29 03 Permit no.: vy zo - 100e�.?
1 v� Ifs - ---- � �° � 7
,,..,,, i i, Of ia� � 3 Sewer permit no.: Building perms n o.:
Ci Address: 13125 SW Hall Blvd. pro)ectlappl.no.: Expire date:
Phone: (503) 639-4171 MAY 2
,) Fax: (503) 598-1960
CITY OF T I G A R D 1 / � Date leeucd. By Receipt no.:
Land use approvagUu ni r niVisiOf� case file no.: Payment type:
• I I' I t► I vi ion i .
•
' 1 & 2 family dwelling or accessory O Commeadal/industrial D Multi - family O Tenant improvement
O New construction O Addition/aluuationheplacernent ® Food service O Other:
•
a ICIIt:SI' IN. +IIIIi11:\1ION II;1:,'t111' ►1'I.I, Iran ~1 . huc(liNI)
s : • / ,!W t '11•111110111111111111111111111m, •1. Fee ea. otal
lob address: t:J . _� /C� <.' _ _ %ii. �i . -a . ■ . P i rlry,w ilii 01 :
Bldg. no Suite no.: o' (Includes Ma2 . for eachanky connection)
Tax ma . tax lot/account no.: SFR 1 bath
Lot: Block: Subdivision: • _ ���
Project name: r = ��
City /coup ,
: _. T . _.� ZIP:" 4 ' 9 . a •: T 9 rr r?�; Irr5.. 10.1 .
Description and and1.e: work on , -. • :: Site utilities:
il �
, ;: „' [V! ' , ,„yj Catch basin/area drain
.don: E' 7"f1InirrT 31 I IIT Tr l''�
Est. date of coca edcn/ins . 116-M,.: an n (no. in. ' MN
1`I.1 11111 \' (l1V l IZ. \( ..... .'rTfTr�'� mr:Irr,,•,, : ,it(+ ��
— rr�
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Business name o es
Address. t • 1 i /V _ _ .. ter.:/_ j • :rrir I , .;•„ . for
City: , , , 'i ,,.� State: ' .. 1 , , sewer no. a. ft.) M
Phone: 46-t - Fax: ,arJ E-mail: — torm sewer no. Wt. �i
A f : r'�no. , 1'11: %ii l� FM
C ne jG *y Plumb. bus. rag. nova . ` Fixture or Items =
d /metro lic: no.: ` ..: ■ on valve
Contractor's re • = sentative signature: � _ y — - _ow . -,, ,. MN
Print name: " _ —_
. ,�/; rt.. + . _
1 1)!V 1 11 1 1'1' PM /N: , avato MI
Name: i,, f1 ,w.(5 .. ill was _. NM _
' � ��
Address: • _ ..._•_ 2.- 1
city: Mitre t . Ste• #, Z • a rnr"'sum INII
Phone: - -Fr?
J v : mall: •-, " "ton ., . = �_
1 111'NI .11 ': , _ :..
W / / C� - !� .:,, , nom .:., : rTTi1sT.�
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Name • rint): , ...7?//. - k/ kJ .:•�rw� !.:, rcrn i. !�r�
Mailing address: / 3r I/ / ;R:frilta aridg!M/�
S ta ra: ZIP: 99 � 2.3 m : �. ...�.. � �
Phone: . - ' , Fax: E-mail: , term • • , . E ms_
Owner installation/reside • maintenance only: The actual installation
will be made by me or the maintenance and repair made by my regular • .. • r't , co , , ii . rl M
employee on the property I own as per ORS Chapter 447. Un�� "'r3RQ21 =
, �=
Owner's • . • -: Date: u
— .I m l 7 shows shower .,: MI MINIM
Name: Tatar c oast II/I
Address: "star eater = ��
City: State: ZIP: a . -r. '
• !one: Fax: E-mail: , n
Minimum fee $ `_!' < tot.' 1A. S
Not an Jwlvdtcaons ascot credit cede, please eon 0 1841 1 for n ae Wbmotlm. Notice: This permit application Plan review (at 40) $
D Vies D Mastor(:ard expires if s permit is lwtobtained State lurch (8 %) $ �l'
exp ; T , ...C, PO
cult card mtmher LI within M* 180
as at r has been TOTAL AL $ �� . d 30
Nero of cardholder as shown an chit card ��
$ 440.4615 (6/00/03M)
eard6older e�urca ArAe�
CITY OF TIGARD - - 24 -Hour •
•
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION ' Business Line: (503) 639 -4171
BUP
Received • Date Requested AM PM BUP
Location _ • L _ I L i_' /S../ uite MEC
Contact Person Ph ( • ) PLM 3 ` D 6 °t 2 7
Contractor Ph ( ) ‘13 s- ' 8 SWR
BUILDING Tenant/01 ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection o es: SIT
Post & Beam
Shear Anchors
at Sheath/Shear
Int Sheath/Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Roof 'd Ceiling /'i
Other: /
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
aA1 ea 13
Sanitary Sewer
Rain Drains
Catch Basin / Manhole .
Storm Drain
Shower Pan
Other:
Fin.
oar PART FAIL
HANICAL
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 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA -
Approach/Sidewalk Date G Inspector Ext
Other:
Final D • NOT REMOVE this inspection record from the job site.
PASS PART FAIL