14170 SW 119TH PLACE C)
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14170 119"' PI
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 &BL
Up
Date Requested_Z 1 AM,//?t PM D
Location y D 5 C✓ /_ 4 I~_A -- Suite y ,{ MEC
Contact Person Ph
Contractor r i' �Q _ Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall _ ELR
Footing Access: FPS
Foundation --
Fig Drain SGN
Crawl Drain Inspection Notes:
Slab __—. Y�� 't'� SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing _ –
InsulationV�LJ.
Drywall Nailing
Firewall
.; Sprinkler
(Fire Alarm
Susp'd Ceiling
Roof
Misc: —"
Final
P �, PART FAIL — --
Post& Beam
itnde lab ,�1A
Top Out Cit'
Water Service --—
Sanitary Sewer %
Rain Drains —
WAA
PART FAIL _ EDE NICAL
Post&Beam --
Rough In
Gas Line -i
Smoke Dampers
Final
PASS PART FAIL _ ! -----
ELECTRICAL
Service
Rour,h In
UG/Slab -- —
Low Voltage
Fire Alarm ----– — – – —
Final
PASS PART FAIL_ ---- -
SITE - -- -
Backfill/Grading _
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$_ • required before next Inspection Pay at City Hell, 13125 SW Hall Blvd
Catch Basin [ )Please call for reinspectiun RF:- [ ]Unable to Inspect-no access
Fire Supoly Line
ADA
ApproachlSldewel. Date �� t Inspector _—Ext _
Other --
Final
PASS PART FAIL DO NOT REMOVE this Inspection i ecord from the job site.
CITYO F 1 I G A R D _ PLUMBING PERMIT
�.
DEVELOPMEN'T SERVICES PERMIT#: PLM2000-00447`
13125 SW Hall Blvd., Tigard, OR 9722:3 (503) 639-4171 DATE ISSUED: 12111/00
PARCEL: 2S110BA-02200
SITE ADDRESS: 14170 SW 1 19TH PI_
SUBDIVISION: ZONING: R-7
BLOCK: LOT: �IURiSDICTION: TIG
CLASS OF WORK- ALT GARBAGE DISPOSALS: MOBILE HOME SPACES.
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 T URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES-
TUB/SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replacing basin/lav, sink, tub/shower,water closet _
FEES
Owner: Type By Date Amou.iti Receipt
NORIN, ROBERT S PRMT CTR 12!11/00 $72.50 27200000000
SANDRA K 5PCT CTR 12/11/00 $5.80 27200000000
14107 SW 119TH PL
TIGARD OR 97224 _ Total $78.30
Phone 1:
I Contractor:
MODERN PLUMBING
11120 SW INDUSTRIAL WAY
TUAI_ATIN, OR 97062 REQUIRED INSPECTIONS
Rough-in Insp
Phone 1: 691-6166 Top-out Insp
Reg#: LIC 87906 Final Inspection
PLM ; 1 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 plays
This permit will expire if l;vork is not started within 180 days of issuonce, or if wo„c is suspended for more
than 180 days. Al TENTION: 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 952-0001-0080.
You may obtain copies of these rules o! direct questions to OUNC by calling (503) 246-1987.
Issued By: 1 i l I. 2D -� _ Permittee Signature, Imo)
Call (503) 639-417F by 7:00 P.M. for an inspection needed the next business day
Plumbin-g Perinit Application
% bate rec eived: Permit no.:
City of Tigard Scwcrp.rmitno•: Building perndtno.:
Address: 1312,5 5W Hall Blvd,Tigard,OR 97223 S_17,
5x1 ire date:
C:iry(!fDgard Phone: (503)639-4171
Fax: (503)598-1960 [��
jed: By: Receipt no.:
Land use approval: _ .nu.: Payment type:
• I &2 family dwelling or acct--ury J Commercial/industrial J Multi-family LI Tenant improvement
U New construction 9 Addition/alterifion/replitcemcnt J Food service U Other: _-
Z/
_I)cscriptirm QIP. hcc(ca.) Tolal
Joh addrCss:�(Z12Q_ �-- New I-add LlamilV dwelii ign 0111Y:
Bldg.no.: Suite no.: (includes 10ufi.Grceachutilityconnectlan)
Tax mapha>'.lot/account no.: SYR(1)bit h
Lot: � liluck: � Subdivision: S(1t(2)bn h
Proiect name: ��) _ SFR(3)ba h _
Cityluounty: _
]ZIP: Each,•ldttional ath/kitchen
---
Dc iption and location of work ou premises: �Iteutil tit a:
Catch hasit/area drain _
Drywclls/li ach lineltrench drtdn
Lsl,date of cotnmplcliun/inspecli°►t' !outing drtln(no.I n,ft.)
t t Macmtuccw'ed ome utilities _
Business name: anholes
Addrem -- R n drain :onnector _ —
City: g1AState 7.IP�C� Sanitary aevcc(noTri.ft.j
Phone: Fit E-mail. Storm scwu.r(no.lin.ff.)
-1Pl'P '" Water sery ce(no.lin.it.)
C(B no.__B�C1Q fz Plumb.bus.reg.no: « 'fixture or item.
City/metro tic.no.: Absorption valve
_Contractor's representative sign t are' Buck flow trevcnter
Print name: 1)me: uckwater wt ve
r Wins/avi to
/ o es was
' er
Natnc: - Dlshwashc —
Address: — -- Drinkin_(iluni un(s) _
City: /1}tj Sti►lc' FLIP: lijectom/sump_— ---
I'Ittnu E-mnd. ;x nasion tank
E ixturc/sewer cap
nwir dcainv/11tx,r sinka/hub
vaunt,(pan(! --- _-- - GcvMtge 13p04al _
Mailing address: Itosc bib
_ Statc�71P_ — _ -- lcc maker
PlInne: Fax: E-mail httercep%r'grrnrc trap - —
t)wner insn►Ilntiun/residentinl maintenance only: '1hc actual installation
will Ire made by me or the maintenance and repair matte by my regulnr Root drain(commercial)
employee on the property I u•vn as Per ORS Chapter 447. Sink(%),has n(o),lava(s)
Owner's si nature: — Date: Sump
IN 10 111 P-- u s/s ow:r/s ower�on _
11Hnul
Name: __ __.___ ater clos st _
Adth'cas; nter 1-1 C-1
Slate: ZIP: Other;
Phone: kax: ti•mail: ate
Minimum fee ...............
$
Nnt all mme InfemuNiunNotice:'flus permit application Plan review(at—%) $
U Vim .i StilAwcunJ expires if a permit fv not obtained Slate surcharge(896) S
t'rrdil card mmth•r
x ir'r within 190 days atter it I nv been
r -
_ _ __ -- - p —
---- ar opted av complete.
Name nr c;udlwlrlrr:e chuvrn nn ttrval effort S
i'unlhuldrt dpugrr-- --- Aowwtr 440.4616(QM'r,M)
CITE OF TIGARD BUILDING INSPECTION DIVISION - MST,
24-Hour inspection Line: 639-4175 Business Line: 639-4171
BUP
Cte Requested C" —AM PM BLD
Location Suite _ MEC
Contact Person Ph " 3/ PLM --
`-' /N�. _
Contractor J►G}v� '� � i� � Ph SWR
BUILDING - Tenant/Owner ELC /3
Retaining Wall ELR _
Footing Access: -
Foundation FPS —
Ftg Drain SGN
Crawl Drain Inspection Notes, --- -
Slab SIT
Post&Beam ——�----------
Ext Sheath/Shear
Int Sheath/Shear
Framing --- ----- -- -
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - — ---
Roof
Misc: - — --
Final
PASS PART FAIL --
PLUMBING
Post&Beam
Under Slab
Top Out ..
Water Service ---------
Sanitary Sewer
Rain Drains /
Final ---- ------ / �� ----
PASS PART FAIL
w
MECHANICAL
Post&Beam ---- ---
Rough In
Gas Line - -- -------.. . _...
Smoke Dampers
Final — --- _
PASS PART FAIL
R ----
Seivir_.e
Rough In
UG/Slab
low Voltage
Fire
% TBS ,PART FAIL _
wffr—
Backfill/Grading —
Sanitary Sewer
Storrs Drain ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin )Please cal'for reinspection RE-— Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date / .4-e% xt
Final
L.tASS_ PART FAIL DO NOT REMOVE this Inspection record from theJob site.
V/