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13220 SW GENESIS LP
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2003-00103
r 13".25 SW Hall Blvd., T.gard, OR 97223 (503) 639-4171 DATE ISSUED: 3I26I03
PARCEL: 2S 103DB-10300
SITE ADDRESS: 13220 SW GENESIS LP
SUBDIVISION: GENESIS NO. 3 ZONING: R-4.5
BLOCK: LOT: 07: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: i
OCCUPANCY GRP: R3 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: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installalinn of irrigation backflow device.
FEES
Owner:
-- — Description Date Amount
CUTONILLI STEPHEN + C'IANA
13220 SW GENESIS LOOP I'I l iMI;I I'rrmi: Err 3/26/03 $3ti 25
TIGARD, OR 97223 I I \\i Stalra� 3/26/03 $2,90
Total $39.15 771
Phone
Contractor:
LEVVIS LANDSCAPE SERVICES
12700 SW NORTH DAKOTA STREET
#180-276 REQUIRED INSPECTIONS
TIGARD, OF; 972:3
RP/Backflow Preventer
Phone : 50,-�24-3679 Final Inspection
Reg#: 1 1( 7267
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Odes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started v Rhin 180 days of issuance, or if work i5 suspender:
for more than '180 days. ATTENTION: Oregon lav/ r-squires you to follow rules adopted by the Oreg(:;;
Issue: By. 'y��7'.�-{, _ Permittee Signature:_ (r1`✓"
Call (503) 639-4175 by 7:00 P.M. for an insvectirm needed the i ext business day
DAKOTA MAIL STATION Fax:5035909734 l°l,_,r 24 '0 P-1::'S
riumaWg rermn,Appucanoo
Cityof Tigard fate received: ,3 fo-3 Permit no. nLM['0o� -x10
Sewer permit no.: Building parmit no.:
Address, 13171 CW Hal.r Blvd, p ---
City of Tigard phone: (503) 639.4171ED Nrojoct/appL ao.: Expire dad: -
Fax. (91M M-1960 p Date issued: BY Receipt no.:
Land use approval: `7 1003 Case file no.: Paymeet tape:
-I 1 do 2 family dwelling or accessory J Commercial/industnal J Multi-fvnily U Tenant improvement
U New constniction WAdditiorJalteratiort/replacement iJ Food service Q Mer:
Job addmss: 2-'Z o lDrrtcriptiaa Fee(ft.) 'total
81 no.: -lqew -trod Z-faadly dwditiow onlP:
Bldg. Suitc no.;
-- 00d"a I"t.fee ascii�rotgwurbr)
Tax ttlap/tax lot account no.. SFR(1)bath _
-- --
Lot: Block:_ Subdivision: --- - - ---- --
.- - SFR(2)beth _
Project name: t S (3)bath
City/county; 'T i W ft - ZIP. Cl 122.$-- - -- Each a ;r!;,-anal bndAitchen
Description and location of work on premises: Shetatmies:
c"` f-,�k� S�r,� Catch basin/area drain _
Est.date of co lotion/ins tion: wells4cwh line/trench drain
Footing drain(no.lin. ) _
Manuf:►ctured home utilities
Business name: ��— Lspc„ S,er,lith Ma es
Address: (1"1oc� S� (La>�J.�*+4- �• Rein drain connector
City: -�T State: �tL ZIP: q�Z i; Sanitary sewer(no. lin.ft.)
Phone: t;2 �a, I Fax: Z►i-5121 E-mail: •itr �,,}N. t� ergD[rrlin-ft.)
CCB no.; l Z 41 Plumb.bus,reg.no: Water service(no.lin.
Clty/metro lic. no.: F7xtarta or Geer:
Contractor's mopresentative signature: -- Abs ion valve - -
Back flow preventer t
Print natne: `S tip% Le oj�`k Dare t y i►3 Backwater valve ------
asins/lavatory - ---- -
Name: Clothes washer— ---- - -
Address; ^(f MJ. - - -Dishwa.her
-
Uinking fountains) --�
City _ _ _ State: ZIP: Ejmors/sump - - -
Phone 51`l-3{o1q_ Fax:11j•:-00% E-mail: xpansi-,n tan_ -- -
Fixtut>r/sewer cap
Name(pnn•): Furor druins/floor siaks/hub -- -
Mail#ng address' e
13Z ZQ S t-J L G a �dis sal
— Hose bibh
Clq: �t r,,�a State: _- ]ZIR 971-L 7 --lce maker _ --- -
Phone:6 jY- r 11 T Fast: E-mail: Interceptor/grease trap -
Owner instauation/rmdetttal maintenance ordy The actual installation 'mer(s)
will be made by iris or the maintenance and repair made by my regular Roof drain(commercial)
employee on the prot►erty I own at per ORS Chapter 447. Sink(s),besin(s),lays(s)
Owner's $t tire' Date: Sum _
-Tu-W-Jxiw`er1s-1iiowet pan
Namc: Urinal
Addre,ta Water closet — -- —
---- - Stair: ZIP: Water heater
City:
Mier:
Phone: ------ Piy --- Email: ISO--
.t Mn4wi�tlnm wixot aM►i cr�tti time cae�eiuucrioe lbr more i�ormriuu. fen............ ... �j
Notice 1INSptirmit nppiicntion Min;mum
tw u M Plan review(at _ ) S —_
Curt c� gam withincxpimif a din,
a is not obtained State wrchme r,8%) .. S '�.'e!o
�-_ ..._ ..._ _... within lE0 do�arise it has beery
A n,ls Li,.W S ►pin
N CO.,senor wt etO* -11 nrd s; r aeecpood as wmpictc Tf1TAl..................... ..
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECl-ION DIVISION Business Line: (503) 639-4171
BLIP - --- -
Received _Date Requested_ `s '2 8 -_ AM - - __PM__ BLIP
Location _ tC) '` ►—�Z.a�s.Q Suite_ MEC
- �Sa JCD
Contact Person __ _ ���_ ____ Ph(--) _1 L7 PLM— -
Contractor --__ _ --__-.--- Ph( -) _ SWR
BUILDING Tenant/Owner (�1,1,; ,�1�1 t,QL1 - -___- _ ELC
Footing w ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes- 1.�,• SIT �S
Post&Beam
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear
Framing --------
Insulation
Drywall Nailing - - - - -- -- �-
Firewall
Fire Sprinkler --- - --- -- -- - - -- _
Fire Alarm
Susp'd Ceiling --
Roof
Other:
Final
PASS PART FAIL
-
Post&Beam --
Under Slab --
r':;ugh-In
Water Service a
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - -
Shower Pan
in
S PART FAIL
ANICAL
Post&Beam
Rough-In - -
Gas Line
Smoke Dampers
Final
_PASS PART FAIL
ELECTRICAL
Service _
Rough-In _ ---- _-- —
UG/Slab
Low Voltage ------
Fire Alarm
Final u Reinspection fee of g_ required befo•e next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL r,
SITE Please cnll for reinspection RE: _ u Unable to inspect-no access
Fire Supply Line
ADA - D 3
inspectorKxt
Approach/Sidewalk path--� --- S.L' � "�
Other:
Final , DO NOT REMOVE this IrIppection record from the jab site.
PASS PART FAIL r