12180 SW 127TH AVENUE 12190 SW 127'x' Avenue
CITY OF TIGARCD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST __--
INSPECTION DWISION Business Line: (503) 639- 7�, BLIP
Received ----Date Requested AM PM--- BUP - - ---
Location _— g� /9-7Suite_ __ MEC
Contact Person Ph( ) 3,5- ALM ---- - -/- --
_ _ Fh( �) — SWR -- --
Contractor -
BUILDING Tenant/Owner ,__ — ELC
Foo—_.ting-
ELC
Foundation Access:
Ftg Drain ELR --- - ---.. - - - -
Crawl Drain '4 SIT
Slab Inspection Notes: -
Post&Beam "—
Shear Anchors
Ext Sheath/Shear r -
Int Sheath/Shear
Framing —�
Insulation _
Drywall Nailing -- -
Firewall ---
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling -
Root _
Ott-er -
Final
PASS PART FAIL
P_LUMSINGI __
Post&Beam
Under Slab - --
Rou h In
er Se•v ce -
Sa Ary ewerkA
Rain Drains --- -___
Catch Basin/Manhole ✓
Storm Drain - --
Shower Pan
Other:
Fin
_PART FAIL � ------ --- ---
_C_HANICAL _ — -------- —�_- z
Post&Beam
Rough-In -
Gas Line
Smoke Dampers --
Final
PASS PART FAIL -
ELECTRICAL -- ---
Service
Rough-in _--- — ------- --
UG/Slab
Low Voltage ---
Fire Alarm
Final F] Reinf^tion fee of s--.---- required before ner.t inspection. Pay at City Hall, 13125 SW Holl Blvd.
PASS PART FAIL
SITE _ F] Please call for reinspection RE: —_-- _ Unable to inspect-no access
Fire Supply Line P ,
ADAcowInspoctor � -- Ext
Approach/Sidewalk
Other:.-_-_
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
f
CITYOF TIGARD __ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: P 18/02 -00490
DATE ISSUED: 12//18/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDIIESS: 12180 SW 127TH AVE PARCEL: 2S104AA-08900
SUBUIVISiON: BELLWOOD NO. 2 ZONING: R-4.5
BLOCK: LOT' 096 JURISDICTION: TIG
CLASS OF WORK: OTR 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: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install 40 ft. water service
FEES -- --- T
Owners --- - — ---
- Description Date Amount
ROBINSON, JAY G BRIGITA –
12180 SW 127TH AVE I I'LUMB] I'ernut I rr 12/18/02 $72.50
TIGARD, OR 97223 1 I'AX18`oState'la\ 12/18/02 $5.80
Total $78.30
Phone
Contractor:
WOLCOTT PLUMBING CONTRACTORS
PO B"X 2007
GRESHAM, OR 97030
REQUIRED INSPECTIONS
Water Line Insp
Phone : 667-1781 Water Service Insp
Reg #: LIC 23847 Final Inspection
PI.M 26.208PB
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. AFTENTION 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 952-0001-0100.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699.
Issued By: Js Permittee Signature: ` c2 �
Call (503) 639-4175 by 7:00 P.M. for an inspection ner`ded the next business day
&Aim09tv Q
P lamb i:ng P eruutA pplication
Date.received: -U Permit no.71—e
„ - Citpof Tigard sowcrpm-mit no.: Buil�;n
" Address: 13125 SW Hall Blvd,Tigatrl. OR 97223 ------ _ s permit no.:
Ciry of Bgari ,
I hoer: X50"3) 619-4171 PFoject/appl_ay.: Expire dare:
Fax: ('501) 598-1960 Date issued: @
yam. Reccipc ao
band ust- appruval:_ Caac file ao.: I Pnyntent type:
I
1 & 'tamtly dwaltng ul acc.-ssnfy J Conuncrcia!,industnca .:I,"tulti-Family -I Tenant improvement
rJ ew construction U Addition/Wicration/replacement O Foal scrvicc j other:
tt r 1
Job address: I�I �� �� D eactlptlun Q ty. Fee ea.' TotYtl
bldg. no.; Suite no,: New 1-and S.family dwellinge uuly:
—-- (Includes 100 R for each utility canuccUanj
Tax ma hax loVaccounr no.: SFR(1)bath
Lot: Block: _ Subdivision. ru bath
Project name: - S FR{3)bath
Cit /county: Tj a 'LLP: r Each additional ba tchcn
Description turd ti work o premises: _ 9Ito Ittititiest
_ Catch ba-%in/area drain
Est,date of com letion/inspection: _ wo s/leach li.ne/trench drain
Foods drain(no.lin.ft.)
PLUBIBING CONTRACTOR
Man acturad hon
B e utilities
Amts'' Rain rain connector _
City. Stat . Zi Sanit sewer(no.lin.ft.)
P 7 FSiomi sewer(no.lin.ft.) _
CCB no.. Plumb. us, �= ate'gelvrce
City/metro Uc. no.: . h. Fi:tu#e or item:
contractor's re resentative Signa e: Absoi tion valve
ac ow venter
Print name: 111-
17
te; �'` ac w+a[er valve
CONTACTstn avatory
L
washer
State: ZIP: jet:t ts/sump
Fax: E trtall: Expansion tank
rxtu. sewer cap
Name(print): oor ins/ oor sinks/hub
Mailin address: atbde disposal
bibb
CI[ _ State: Z1P: ice maker
phone: Fax. E-mail: nterc tor/pease trap
Owner ittstalhttioNtesidential maintenance only: The actual installation im s
will be made by me or the maintenance and reipaix made by my regular Roof drain(commercial)
employee on the property 1 own as pwx ORS Chapter 447. n (�),basin(s),lays(s) '-
Owner's si ture: lla1.. _ ,um _
t.� r tower/s ower pan
Name- Urin
Adaress: W ate closet
Wate heater
City: ~- -_ Ststc: IIP:
Phan rax: _ E-mail: Total': `-
Nto ivroditlbm edrtpt credit cud. piece call jenelkdon bNotice' Thu permit
r Mort 100newel. applicationMinimum fee.................
0 hluterCsrd expires If a permit Is not obtains Plan review(at — %) S
Cledu card nemoar i I �.L within 150 days after It has leen Stare surcharge(3A6) ... S
eepref TOTAL......... .......... $
Nelle of coo ear tt shown on[r If cord accepted aS complge.
w- 1i1011f110t1 11�teltlft ^p1pYn1
4AI.4616 1Na0/CUM
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