Permit Jam. i
A .
CITY OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #: PLM2003 -00296
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/23/03
SITE ADDRESS: 08021 SW VIOLA ST ; PARCEL: 2S112BC 09400
SUBDIVISION: RAZE MEADOWS ZONING: R -4.5
BLOCK: LOT: 017 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: 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: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: SUMP PUMP
FEES
Owner:
Description Date Amount
NORDLUND, SCOTT + CINDY B
8021 SW VIOLA [PLUMB] Permit Fee 6/23/03 $72.50
TIGARD, OR 97224 [TAX] 8% State Tax 6/23/03 $5.80
Total $78.30
Phone :
Contractor:
NORTHWEST CENTRAL PLUMBING
2870 SW 221ST
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone : 642 -2067 Rough -in Insp
Final Inspection
Reg #: MET 00001690
LIC 72253
PLM 34 -197PB
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: 7 Permittee Signature: ( �I �_0 _�
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business • ay
•
JUN-23-2003 10 : 22
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•lani Permit Application
N E , Received 1-k 1 t' t...1:. 1 , 1 N1.)
Plumbing n -
II
1....) D3 - ' ' ' rnnt No.r
Cittiii Tigard RECE Plzuning Approva Sewer
Datea ; PenTtit No.; .
1315 SW Hall Blvd.
i4 l tel 03 Noe Review Other --'
O
Tigard, Oregon 97223 IV' Dslelly: Perlriil No.: i
Phew 503-639-4171 Far 503-598-1960 ,.... . . . ARO Poulet Land Use
Internet www.d.figgrcLorms C 1 'SION Cam: Com No.;
Juris : 1 tgi See Page 2 tor
244hour inspection Request; 503 B ' is - • --- wanigtmcaye- 1 Svapiesnantal latoratation. i
1" : .. ' -44 :. : 4 1 . )1 4 ; 1 : TWOOF WORK ; .:.. • . " 1 I.,,1 . I. ... , ..,... - ;' FM' L.SCRED E Or yjiicillinfOrnilibitisiitheciaiSOL , I
II New construction • Demolition Description I Qty. I Fo(es-) [ Total
111 Addition/alteritionfr .lacement IN Other. M ,vp ye eeet' 1 : 1 .! I 1 :.!! . ' .. 1 ;
.CAT : v ' . 'Or .t.. • . • . • • CTION • • '1;4 . - - . ' . • kWbda•_1006. enatiaiiina) '! I . • , r
SFR (1) bath , 24920
ligt 1 & 2-Famil a. ;. , mg Commercial/Industrial
sFR(2) bath 350.00
IS Mc= - • Buddin .-_ 1! Multi-Fann RR (3) bath _ 399.00
fp Master Builder I. Other! Each additional trials/kitchen , "■
• I- - ' TIM aid .ril w 2101 ., i'•. :i'. •t' Fire spriolder - srL ft.: p 2 1
Job site address! Se . S V 1 idi Sr , 1 :,.,... 0. i:i Tyi;. . •.. ,sweigitia or:6, . .. '..
Suite 4: Bid: ./ . .t.4: awl basin/area drain ..__ 16.60
r
DrywelVleach line/trench drain - 16.60
NO Nate: o - a. A , ---
F codas &ail+ (po. lions ft.) hni_
Cross street/Directians to job site: Manufactured home utilities 110.00
Mortholea 16.60
Rain drain connector 16.60
Sanitary sewer (no. linen IL) Page 2
SUbdiviSi011: LOt #: Sturm sewer (Ito. linver ft.) _ , Prigc 2
Tax Tea I a.- cel #: Water service (no. linear ft.I Pgic 2
- • : i- '. ' o.I 'Hittite or ltenik ; .'‘•'.. .... 1 .. 1, ''. •'. .
. • •
1 : ' ' •i.' 1 1 . EIESULIPTION OF WORK . . ] • , • • ...: . .1
- . Absorption valve 16.60
..e;stu1 /
Backflow pre-venter Page 2
1 f ;
Backwater valve 16.60
- t Cloth= washer 16.60
. -
MIIIIII&AMIIIIIIIMIIIIIIIIIj Dishwasher 16.60
Ortoking fountain 16.60
Ea loft '_-L:Iiie. yeas.. , ,!,.....ntiamtiammi Ejectors/surnp 5 u.„by; Pa..? / 16,60 /4.40
Name: , o ral /14.4,1 Expansion toils 16.60 _ _
•
Address: se .2.- S W i 0 a S. Fiamresewer Clip 16.60
Ci /Statert • : 7""' &.,r- 0 k ? 7 a 2- Floor drain/now iinicihnb
_ - - 16.60
........w Gubage dispoial 16.60
• 1 • ii • ; Fax: Hose bib 16.60
.,Igiurviirrh. , •rilt . ... .. lite irwM .__7-77011111111 ke MOM . 16.60 _
game: iticrececurigreast tr3:1 16.60
MIMS: Medical • • - value: S P • 2
Primer 16.60
Ci /Stateai • : Roof drain tomrriercial) 16.60
Phone: Fax: sinasisviavatory 16.60
E-mail: Tub/shower/shower pan 14.60
'• '.•:,' ' •'.' .. ' .- ' 1. IP if.; .. ;: . • . :.. , 1 Urinal . 16.60
Water closet 16.60 i
BusinessName: Northwest Central P li i ng water heater 16.60
.
- . • - 6: • 4 2 1 s t . : I. Other.
Ci istaterzi.: OR 9 7 1 2 3 Other. IMINI .
L__Aerinit Fate"' - : 1.. • . • • . , • . .
ph 5 0 3 - 64 2 - 2 0 6 7 Fax: 642-5954 _...1,i_
Subtotal S 7 g *•-r
CCB Lie. #: 7 2 2 5 3 Ai r Fr.b. I_Ac.4: . _ • pB Minima/0 Pettnit Fee $72.50 S
' Authorized ' ' 12fir Residential Backflow MinhnumFee $3625
Signature: -- r , _A Dare: Plan Review % of Permit Foe 5
____,&i L ti V "r 7 •""t' s State Surebetge (8% 01- Permit Fe* NEM
(maw print name) TOTAL. roller FEE f.
Notice: Thiu pensdt application-expires if a pernth le mot obtained within All new astamercial buildiaas require 1 sets otos** with isennewle or
1110 days alter it has been accepted as complete. river diagram ler plea review.
'lee methodology bet by Tri-County Betiding Whimsy Serleke Board.
i.TOSISTCTTnit FOrfINVIITIPandtAppttoe 01/03
ell 4-' C-44" '(
. -
CITY OF TIGARD 24 -Hour •
BUILDING. Inspection Line: (503) 639 -4175 • MST
INSPECliON DIVISION Business Line: (503) 639 -4171 . •
BUP
Received Date Requested AM PM BUP
Location 7e))_ 1 Suite MEC •
Contact Person Ph ( ) (£ �� i� PLM 3 -bD a-9,
Contractor // Ph ( ) SWR
BUILDING . Tenant/Owner _57 ( - 7 r? c
Footing
Foundation ELC
Access: c.
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ,p SIT
Post & Beam O U./Mr -1-10
Shear Anchors
Ext Sheath /Shear '! a /./%
Int Sheath/Shear
Framing
Insulation
Drywall Nailing /
Firewall /�
F
411
ire Sprinkler / - 4/1 /9 � ` '
Fire Alarm • • 4. _A %`1 L r / - � . �� •
Susp'd Ceiling - - -
Roof
Other: •
Final
PASS PART FAIL - C
PLUMBING
Post & Beam J ( c / O J -
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain AMIrgeill&
Shower Pan
Other: wordy
Final
PASS T FAIL /
MECH • CAL
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 L Inspector Ext
Other:
Final DO OT REMOVE this inspection record from the job site.
PASS PART FAIL