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12350 SW BELL CUNT
CITE( OF TIGARD __ PLUMBING PERMIT
DEVEs' .IOPMENT SERVICES PERMIT#. PLM2003-00182
13125 SV Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/7/03
PARCEL: 2S104AA-01200
SITEADDRESS: 1<"1350 SW BEI_I_ C l
SUBDIVISIGN: BELLWOOD ZONING: R-4.5
BLOCK: LOT: 061 JURISDICTION: TIG
CLASS OF WORK: REP 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: ZF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SE'vVs_R LINT: ft
WATER CLOSETS: WATER LINF. 1t;(? ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace 160' of water service.
__ FEES
Owner:
- Description Date Amount
SMITH, JANET C IPLUM131 Permit Fee 5/7/03 $101.40
12350 SW BELL CT
TIGARD, OR 97223 [TAX] 9%o State Tax 5/7/03 _ $8.12
Tutal $109.52
Phone
Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : 691-6166 Water Service Insp
F inal Inspection
Reg #: MET 00002486
LIC 87906
PLM 34-250PB
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
Issu B \., i' Permittee Signature:
y L
Call(5 9-4175 by 7:00 P.M. for an inspection needed the next business day
05/06/2003 14:45 5036916771 MODERN PLUMBING PAGE 02
Plumbing Permit Apph:cation
Date received;!` 7 e Permit ro 1 Lot aa)3 t)l>/9s(
City of Tigard
Ai; Sewer permit no,; permit no.:
Address: 13125 SW Iloll blvd.Tiyjrd,OR 91223
Cary°f Tigard Phone: (503) 639-4171 ProJec!/sopa no.: Expire date
Fax. (503) 598.1960 Doty issued: By:"-. I Recotpt no.:
Land use approval: Case file no.: Payment type:
3f&2 family dwelling or accessory U Colttrnercial/industrial J%111111-lamely ❑'Tenant improvement i
Fl Nrw rnnsimiriicrn U'Addition/atteration/raplric.tment rl Fone crrvirp (](1llter
1 1
11r arr i rrinn Uty. hr r(ea.l :1]otaI
Job address: i`!- I _
Lv. a< !_
Bldg no.: Sttita Ito. New -and 2•tamih,dricllinl;a anlv
_ �----- (ineludea 100 ft.for each ntaiti cannerti
Tax ma /tax lot/account no.:
-..�� 5FR (I)bath
Lot: Block Subdivision: SFR(2) bath —�
Project name. SFR(3)bath
City/county, Lo 14 1 71F: ,7731 Eno t additionol both,kitcheu
Despc�ription and 1 catio r of%vork on prerttises- Site 1101100.1t
Catch basin/area drain
— = �•..-Sd � -� Q —
Est.date of complctionlinspcction. 5 — -��? - ur we Isdracti line/trenctl drain
a t
Foolingdtain(no. in, ft.)
Manufactured home utilities
Businra.,uumr t1Al� anh0 es
Address: C) Std J_A4 4 -` sin drain connector
Ci Siater)yL 71P t^ alSaniwr sewet(no. lin, ft.) _
Phone: - Fax C( E-mail: Storm Sewer(no, lin.ft.)
CCB no.: (� Plurnb, bus,reg. no; Fater service no. [Ill. ft,
City/metro Ile no.: "__�Fixture or item!
Contr>actor's representative signntur BockAbsotion valva
_
��*, �K�"iP''*-� Buck i1nw praventcr
Print ream L'l?v:59f .5 b103 Bush ntcrvave
Basins!lav,t(pry
Name: C'iothcs wnshcr
Address: - Dtalrtva»Itrt
Cit State: zip. Drinking fountain(s)
w
Y' Ej cc tot's/sump
Phvum. f F.-snail. Expansion tank
f ixture/sewer clip _
Nlame(print): Floor rains/t oto sucks hub__
Mailing address: - Gamer a e is osul __
Hosc Bibb _
City: State. Z1P: lcG maker
Phone: Fad E-mail: Intcrccpmor/Itreose trap
Owner installation/residt-tial maintenanec only: The actual Installation Primer(s)
will he mnde by me nr 1:ic mninlenance and repair made by my re¢ul+r R nnf drain(commercial)
employee on the property i own as pet-OILS Chapter 447. 5mk(s),basin(s).lays(s)
Owner's signature. Date: Sump
Tubah. ow•dr/shower ran
Urinal
Name: _._ water c oset —
Addrecc: Wulrr I+rcua
City: 5iote: 7_iP: Oc cr:
Pitons: Fox: E-mail: ottat
tit inimum fcc...
Not alt Jur{6Aletlnnr++cecpt cratli unrJr,n' +K t,n pnietl+:uan
tormom Intrm+;nl,n. Notice: 11tis pentltl npplication n
v vlxa •r--- Plan review(et
DT L+ expires if n permit is not obtoined State surcharge(8%).... S
cmdl+tart o..... within IAO days arer it has brcn
R V K K.v t ap+nr TOTAL....................... S
mac p eJ cat t 8t 11144' )II tf ;a,;n)
ncccptcd as compass.
Ian 4616 rNWCOIA
-- n tlCr f nnrnri .roma ul
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP
Received _ Date Requested__.- '!�- 7-- _ AML-- --- PM _ _ _-_ BLIP
Location �__- 2--t Suite _ -- MEC
Contact Person _ Ph PLM
Contractor
_— Ph (------) SWR ------
BUILDING Tenant/Owner
_-- -- - ---. ELC --
Footing _ --- - -- -_
Ft a
Foundation Access: , ELC
g ELR
Crawl I -ain _ --- -- ---
Slab Inspectio otes: SIT --
Post&Beam _
Shear Anchors
Ext Sheath/Shear
IntSheath/Shear
Framing --- - - --
Insulation
Drywall Nailing — -
Firewall
Fire Sprinkler __--
Fire Alarm
Susp'd Ceiling -�}-- -
Roof
Other:
Final
PASS PART FAIL -- ---- ---
PLUMBING
Pest& Beam - - - -
Under Slab
Rough-In _
i
San ary ewer
Rain Drains -
Catch Basin/Manhole —
Storm Drain --- -- - --
Shower Pan
Other:
Fi
A PART FAIL -
CHANICAL
- - - - -
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 SIN Hall Blvd.
PASS PART FAIL
31TE ---- Please call for reinspection RE:__.._ _ Unable to inspect-no access
Fire Supply Line '2
ADA
Approach/Sidewalk Date _�-!. Inspector_ ! Ext
Other:
Final DO NOT REMOVE this inspection record from the Job trite.
PASS P.,AT FAIL
CITY CSF TIGARD MECHANICAL
DEVELOPMENT SERVICES PE:RMI i
PERMTT #. . . . . . . : MEC97-0024
13125 SW Hall Blvd., Tigard,OR 97123 (503)639.4111 DATE ISSUED: 0. /0y/97
PARCEL: cS 104 AA-01 ::'00
--ITF: ADDRESS. . . : 123150 SW BE_I_1_. CT
-i1JBD I V I S I ON. . . . : BE LLWOOD 'Z ON T NG: R- 4. 5
(sLOCK. . . . . . .. . . . . L..OT. . . . . . . . . . . — :61
!;LASS OF WORK. . .ALT FLOOR FURN. . , . : 0 F=VAP COOLERS: 0
1'YPF_ OF USE. . . . :SF UNIT HEATE-RS. . : 1 VENT FANS. . . : 0
f)CCUPANCY GRP. . :R._, VENTS W/O ADPL: 1 VENT SYSTEMS: 0
=TORIES. . . . . . . . : 0 BOT1_CRS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPE=S- _.... _....._--.- .. _. __- 0_3 HP. . . . : 0 DOMES. INCTN: 0
: /GAS/ / / 3-15 HP. . . . : 0 COMML. INCIN: 0
11AX INPUT: 0 B"rd 15 30 HP. 0 RE. PA T R UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
3A':i PRESSURE. 50-1 HP. . . „ : 0 CLI) DRYERS. ., . 0
1qO. OF UNITS --- ------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 1001'. BTU: 0 (= 1.0000 c:fm : 0 GAS 01..ITL.FTS. : 1
':URN > =1001 BTLI: 0 ) 10000 r_f m : 0
Reme.rks : Tnstalli.ng dir-ect vent room heater, incl piping
flwner: _.____.___.___.__.________._____________.-_.____---_•—_----_—____--. FEES
iAN -1)MITH type amount by date r-e^pt
12350 SW BE-LL CT PRMT $ 25. 00 B 02/O5/97 97-289970
SPCT $ 1. 25 13 02/05/97 97-289970
T CARD OR 97222
r'hone #: 590-9056
',ontractor,: --___..--
OP&W SYSTEMS INC
13MARBLE RD
WASHOUGAL WA 9B671.-9601
-'h o n p #: 360-835- 3516 26. 25 TOTAL_.
1eq #. . : 001081
REQUIRED I NSPECT I ONG
This permit is issued subject to the regulations contained in the Gas I-i.ne Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Tnsp
applycable laws. All worN will be done in accordance with Final Inspectincl - -
approved plans. This permit will expire if woo is not started
within 19N days of issuance, or if worts is suspended for more
than 1610 days.
!-'pr,mi.ttpp Si r n-0t1u•_
91_red BY :
Call for inspection - 639-4175
City of Tigard MECHANICAL PERMiT Planck/Rec. #
13125 �W Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
Table 3A Mechanical Code QTY PRICE AMT
Job •,- 5 v. 1) Permit Fee -0- -0- 1000
Address p
2) Supplemental Permit 300
Furnace to 100,000
-c ',( 1) ncl ducts 3 vents o 00
'•' ^• Furnace 100,000 BTU
Owner ' 'wwiL. 2) incl ducts &vents 50
Floor r Fumance -
3) in^,1. vent 5 00
-- •"•""^•"•° ^•••
Suspended eater, wall eater
.1) or floor mounted heater 600
o •" "",° --went not inc i�n
Occupant
5) appliance permit 3.00 �
Repair of heating, re ng.
6) cooling, absorp ion unit 6 00
•
Boiler or comp, heat pump, au con
4c, 7) to 3 HP, absorp unit to 100K BTU 600
1
Boiler or comp, heat pump, air r_on
ContraCtOr - 8) 3-15 HP' absorp unit to 500K BTU 11 00
_ ----Moiler or comp, eat pump, air cons.
LkkA- ,u 1 d ? 9) 15-30 HP; absorp unit 5-1 mil BTU 1500
Boiler"No or comp, Heat pump, air con
`45 �� �51� ��/ 10) 30-50 HP. absorp unit 1.1 75 and BTU 22 50
hereby acknowledge that I nave read tis application that the Boiler or comp-7eat pump, air ccnd
information given is correct, that I am the owner or authorized 111 > 50 HP absorp unit 1.75 mil BTU 37 50
agent of the owner, that plans submitted are to compliance with it handling unit to
State laws, that I am registered with the Construction Contractor's 12) 10.000 CFM 4 50
Board. that the number given is correct. (If exempt from State Air handling urn
registration, please give reason below) 13) 10 000 CTM + '50
Non porta 7e-
1.1
1.11 evaporate cooler 4 50
ent an connected —�
i 151 to a single duct 300
-�
Ventilation system not
07 5 16) included in appliance permit 4 50
Hood serve y
mechanical exhaust 4 50
escrr a work ne addition 0 aeration repairommerciTndustria
to be done residential Q non-residential Q 18) type incinerator 3000
Existing use o ter i.e. woo stove. water
budding or property 19) heater. solar, clothe- dryers. etc. 4 50
Proposed use of 20) Gas piping one to four outlets 2 00 l_
building or property
Type of fuel -oil Q natural gas 0 LPG Q electric Q 21) More than 4-per outlet teach) 200
NOTICE
Minimum Fie $25 00 SUB
TUtAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION -TO
,AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE Z5
IF CONSTRUCTION OR WORK IS SUSPENDED OR r --
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER 'A1ORK IS COMMENCED — -
TOTAL ! zS
Special Cmncilions
'late ssued by
G:MCSTTkiECHPMT