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CITY 9 O F T I GA R D v— PLUMBING PEPMIT
DEVELOPMENT SERVICES PERt111T#: PLM2002-00301
13125 SW u +II Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/31/02
PARCEL: 1 S136AD-01901
SITE ADDRESS: 069' '1 OAK S1
SUBDIVISION: VILLA .dDGE ZONING: R-4.5
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOS4LS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH BACKFLOW PRFVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES_ _ _ AUNDRY TRAYS: SF RAIN DRAINS:
�TSINKS: URINALS: GREASES TRAPS:
LAVATORIES: OTHER FIXTURES.
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 60 ft
DISHWASHERS: RAIN DRAIN: ft
Rer^arks: Install 60'water service
FEES _
Owner:
Type By Date Amount Receipt
MILLER,OVIE A TRUSTEE PRMT CTR 7/31/02 $72.50 27200200000
6910 SW OAK 5PCT CTR 7131/02 $5.80 27200200000
PORTLAND, OR 97223
Total $78.30
Phone 1:
Contractor:
JACK HOWK PLUMBING
1910 NW BURNSIDE
PORTLAND, OR 97030 REQUIRED INSPECTIONS
Phone 1: 235-8784 Water Line Insp
Water Service Insp
Reg #: LIC 146779 Final Inspection
PLM 26-288PB
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 Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0000.
You may obtain copies of these rules or direct questions to OUN3 by calling (503) 246-1987.
f
Issued By: � �l r i L )1 , ! _ Perrnittee Signature: L
Call (503) 639-4175 by 7:00 P.M. for an inspection needKd the next business day
Plumbing Permit ApplicatiOn
Uatcrt:c:aiverl: Porttdtno.: ,
City Of Tigard SCWer rnroit nol, Building permit no.:
Addreats: 13l?-5 SW Hall)1lvd.'I'lgard,OR 97223 Ita)c:Uappl.nu,; tixpitedate:
G'ir;gTigard Phone: (503)639-4171
Fax: (503) 598.1960 Date issurd; �- Lay: Receipt nom
> J
C;,ayn file ro.: I PAymenttype.
Lund u:;:.approval; _..._.�__-_-- -
af 1 a2 family dwelling or sex Cisenry U CommerciuUindusttial 0 Multi-fautily U'Tenant improvement -- '
C New cuttstruction Q Addition/altemdonlreplaceruuntIMP1916MMAUM KILUJIM"I"E"H11 all=
U Fxxl ye.tvi�e U Othur:
Uelcrlkdon tjty. !Ce(en,) 'futal
Job;xldraAs: ���S� —__` --_-- Novrl-tt�nc .• stnillydwrllireganr y:
8idg•nt).: _jSuite no.: (Includm loo ft.for each notitycnnneetlea)
Tax map/tax lodaccoant nn.: w SFR 01 hath _ _-
I.nt: _ Block: Subdivi ' n, SCR�)hath
ectntune; V R(3)bath r
ru„ _ Ent Ari tarn flat tt: n _
rityiwun / _ fi;teutalttcsr
UescripHtxt and lucatinn o�)wo rc�tn ilsea: .fit (;etch bxsirttlarra brain
Ix wcA/leac)t Ime/trent drain
ryt.date of completiun/inA tion, 3 oohu drrtln no,
snutsctuM bv_tn_e utilities
nur+ituas namt: l ti anho e
Address Sita rirnin Bower
n tar
Cit �Q. [ t _ 5cate; ZiP a"j Sentra c+wor no,lin.ft.)
Y t- hftx:{ •,a9" F nW1: Sturm se . r no.lin.R.)
Phone: -
__r 3,,t�LI_ -1—__ -- Water eervicc no. int,a.
CC13 no.:f y ! __ �t'ptb.bus.reg.no; `b FIxtttre or Item:
Cftylmetro lit.no., ' AhsurTtiun vnlvc
L tractnes represenmove eiPnaturtt: - ark flow r�eventer
flint nanto-�!i f� fit/ iii Date �' 0 F3a_watL vale
Basin lavatory ,.
Clothes wasttnr
NA,ne: rns was ter
Address: - _ Diinlotutltiiu(y)
city r - State: 'LIP: star gtun —_ .•..._
Phone: Fnx: E ntell: Expansion tank
-
aeworc - - --
FlrnOrdmit nnnr sinks/hub
Name(print): _— _ -- arbae dis>n�_
Muiliva address _ iose Bibb .�.
ZLF �. cc maker
. 1Phvne: Qax: )>•tnatl• , ntetcC t�SC —
Owncrr inuollataott/reaidentird maintenance only: 'Ihc ux:tw+l instaltiar n Primer s) _ --
will be made by ma of dle maintaoartce and repair mride by my rr'g RC.) drain(.mmereial
empinyee on the pnperty 1 own as PUT URS Chapter 447. STs), est (s),_."vs(")
UDate; unt
s�.�nor's r;ignnture: - ubs/shower/sfiuwer pan_ -
tina�
Name; __ _---_ -•---- Wntcr closet
Watc+r eater
Address; —_-- -
city, Sinn.: IIY: _-- Vther:
-
E-mail:
otter: Fsx: _
---- _ Minimum fee,....._........
mot eU)utird1000Mweep( Card,.plain' JthuildlCfanfor OR 00. Noice:-(itis permitapplicntim PIAntevtew(at _ '70) $ _--
UVise 0Mea Id exphvs if apurmit to ontobtailm, State Furchatyn(8%1 ...$
CSCdh,Ud gtnntc7: -� Ex 106 within 190 days eRm it has been
_ ancepted M complete.
Name ll est t u ni NY+Wnoa rte li uv�1
401616(6RlalCDM)
t',3 2160'OW 'JNIHWfI�d :v(_fl-Maar wdza:s 2002 Vir
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
/ BUP - - —
Received _ _ _. - Date Requested_ gr AM PM__ BLIP
Location _ _. c��G -Suite___________.L_. MEC
Contact Person Ph(-) 3 "���7 PLM
Contractor _ Ph(---) SWR _
BUILDING Tenant/Owner _ L + 1� 1� ELC
Footing FLC
Foundation Access:a2
Ftg Drain ELR
Crawl Drain - - - -- - -
Slab Inspertion of s: , - SIT
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing _
Firewall �►j/'
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling -- 00- -Roof
-
Other: ---
Final
PASS PART FAIL - -' -i- -- -- -
PLUMBING-
Post&Beam
Under Slab
Rough-In
--
Sanitary Sewer / --
Rain Drains
1
Catch Basin/Manhole
Storm Drain - - - --- -
Shower Pan
Other. - -- y---
j
AS PART FAIL
HANICAL _
Post&Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL -- --- - -
_EL.ECTRICAL
Service
Rough-In
UG/Slab -..-.---._--- ---- _ ._-
Low Voltage -------- - -- --- --.,� �T�_
Fire Alarm
Final Reinspection fee of$__ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd.
PASS PART FAIL
SITE [ Plesse call for reinspection""::____ _.d _ Unable to inspect-no access
Fire Supply Line
ADA .
Approach/Sidewalk DatM1_L/� '' Inspector -----_-_---- - .
Other:
Final DO NOT REMOVE this i"spectlon record frim the Job site.
PASS PART FAIL