Permit C ITY OF TIGAF2D PLUMBING PERMIT
A-tvie DEVELOPMENT SERVICES PE DEVELOPMENT PLM2003 -00352
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/18/03
SITE ADDRESS: 13000 SW WATKINS AVE PARCEL: 2S102BC -03500
SUBDIVISION: ROSE TERRACE ZONING: R -4.5
BLOCK: LOT: 002 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:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 32 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: WATER SERVICE
FEES
Owner:
Description Date Amount
RON JENSEN
130 00 SW WATKINS AVENUE [PLUMB] Permit Fee 7/18/03 $72.50
13000
TIGARD, OR 97223 [TAX] 8% State Tax 7/18/03 $5.80
Total $78.30
Phone : 503 750 - 8937
Contractor:
CROWN PLUMBING
5429 SE FRANCIS
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone : 503- 771 -9449 Final Inspection
Reg #: LIC 42671
PLM 34 -70PB
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: � Pp Permittee Signature: �� � / ✓� _ _� _' . _,�
Call (5039 -4175 by 7:00 P.M. for an inspection needed the next busi es day
JUL► -17 -',003 02:41 PM CROWN, PLUMBING 503 771 9454 P. 01
711(0 3 eLlnaCrO - 00350-,
• P1 pilcation
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, t1 ;�,) +.. .• 't - , ow= .. Buildingpaaltno::
Add tcss: 131 i 1 -
an gwd note 1503) a � 1� �,. + � t , ' -- . '- /appL s o.: • Expire dee=
• r ” Fax: (503) 548- Of I1 ,. 1 ''" "-~ Date isiiisdReeelpt no.: B
1
.. Lind use aP ~ -� Or tue ao.: Payment type:
II vi l) I pi .loin •
- 1 lit* family dwelling t i :ato a o r y `tl • . -; -; ,,O Mull - familyi .. 0 Tenant i m p r o v e m e n t ' - •
• Nevi caeattirction ' ' Addition/dtemdou/mpl � • O fo selvlce { O Other: • : .
.111IISIII, INI1111,NI11ION I t:l: 1( 'II1 Dili . l. (tor . Nig Liol1111urma,ivuli,t titt,I, list )
Job address: p a 0 51.! UJ Gull C1 ‘rdy }. : --.. -1- _."','-. Descrl . , ' I f ees.] Total
Bid no.: , :,'( :a . ' %%dte no.: W'' T _4' TI I. , , . •
Tax lot/account no.: • - - Qlsci . i b at :--1 ealdt udikyoonnelxloll) •
Lot:... � • Block' Subdrvialon: SM i ��_,. --1 ea
LIT N
• , emu= . • • 1 • , l w. ''. - 1 .14 gaK+.:l $ , ■ I1Lat m,
a , f . : .., - ; ' - -; „a z@:. - .. j .. 9 .,., k. , 1. 717 r: . ,-,'M_ .
Deacdption and location of work on premises: w e u,a:, , 1 Slt udlNlss • 1...
oft d am•• - - . -1I.)tk .:c "cwt ;.1- in •t• ;r ' , Catch basin/aim drain
13st.datoof ;, •iwotl/Inspection: —4- -- - - . •1. -- ! 7 -1 1 - - , M,-.In /r?^1rr -+lam . T' "Mil= --
t•t:unitliNc: i:I)N i lt,1r °rryli Ili:•.., ,rt . no. 1 • = �•
Business name: • - . _ Y` M _ I ■ 75 w — . - -
Addreu ' . - ' • r10CVN 'e. k • • . s •11 , . connector
a .� - Li e.A 'ZIP: j:•.j;;• {f?'!�1)r1
' •ne: 7EL'LIIMI :1 finri; l main ^. _,, - , .. WP- , '• Ir Vfl'i ► — ��
COB no.: ,1 Plumb.bug.re • . • , . lip`s' : ,. : - .a['I: Ir;3M [E
C ity/metro lie. no.: .— _ � . 1FIi[t e a It
Dontrac6olra ve . , • • AFI N --
i r „ . �� . Date:' `' in 'O t OW • , .. ILMA=MEN1=111.111111111. MI 11111=11
( ON 11( I I't',I(SON :. , rrr avato ; MINI 111111•11
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State _ Z2P;......,t 1127,71 ®,,, - .
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Phone: . - Plot: B- mau: - - -- - • .1: - ..., ,; _.,,,,:. a MIMI
Owner dential maintenance only 'Ctn: wool I W111tion - �.i.It v
wW be made by moot the maintenance and repairmade by my regular . ! ( ;• , ,, , ,,:‘,.; n 1A111.1.1.11 — - -
employee on this propelly I own as per ORS. Chapter. 447. • 1' • "" LiTIO=OMMTOMI M _
Name: 1 -...... t m 11=11■1 /Hi MOM
Address: • • • • - • "ater ,- wa
City: State: ZJP: • l , _, . • ME M=
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Phone: Fax: &mail: illallibliMill111111111111111.1111.11111111 • • NM
Not as jdts � mows awl curds. phonon 11rt boa toe mow kite ttitioo Notice: trip• ,, � app
'„'' ' ., " Minimum iee...........„ $ 7pZ / .__) .
&Visa O marr ward expiry If permit i l s tat chained plan review (at _ %) $
f t a
/ .. .f _ within in days niter it bas been surcharge (8%) ..•. s 75N
- � accepted se complete. TOTAL 7 . 2 alai
•�' [ . Amount 110.1616 (61f0'CDM11
11/16/2004
Case Activity Listing 2:03:38PM
TIDEMARK Case #: PLM2003-00352
COMPUTER SYSTEMS, INC
Assigned Updated
Aetiiity2-'1:1escriptiO6 r Date 4 C BY Notes
PLMA003 Application received 7/17/2003 None DONE FAX 7/18/2003
JMT
PLMA005 Create Permit 7/18/2003 None DONE JMT 7/18/2003
JMT
PLMA005 Create Permit 7/18/2003 None DONE JMT 7/18/2003
JMT
PLMA799 Final Inspection 7/25/2003 None PASS MRS 7/25/2003
MRS
PLMA050 (F) Issue permit 7/18/2003 None DONE RCP 7/18/2003 •
RCP
PLMA800 Case Finaled 7/25/2003 None PASS MRS 7/25/2003
MRS
Page 1 of 1 CaseActivity..rpt
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION - Business_Line: (503) 639 -4171 MST
BUP
Received Date Requested • 7 AM PM BUP
Location /3 4006 I Suite
Contact Person A- 1\e■--/ Ph ( ) .75 — 8 3 7 PLM 3 - D D J.So2
Contractor Ph ( ) S R
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: /c; — 3 SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler V -
Fire Alarm
Susp'd Ceiling
Roof
Other: / -
Final /
PASS PART FAIL ,
PLUMBING
Post & Beam
Under Slab
Rou • h -I
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
F -
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 Li 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 Inspector Ext
Other: /
Final DO NOT REMOVE this Inspection record from the. Job site.
PASS PART FAIL