11620 SW LOMITA AVENUE .a
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11620 SW LOMITA AVE
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: %503) 139-4175
MST
INSPEC LION DIVISION Business Line: (503) 1539-4171
BUP
"':ceived ate Requested AM PM ��.�-� BUP
/ / / M1
Location _.1[s !�: 4n:i �— Suite — MEC
C.ntact Person Ph(--) -hAl" 2542 PLM
Coi,tractor --_---_---.----- --- — Ph( ) – — SWR
BUILDINGS —� Tenant/Owner -_ - _ _ _.. ____ ELC
Footing ELC
Foundation
Ftg Drain �ocPSs
ELR
"( IIIJJJ �-
Crawl Drain _ i
Slab Inspection Notes- �- /� )) SIT -- --- —
Post&Beam (iCJG `CJ2
Shear Anchors ---- - --`-
Ext Sheath/Shear
Int Sheath/Shear
Framing - ----
Insulation
Drywall Nailing de - —_
Firewall
Fire Sprinkler - - — - -—
Fire Alarm
Susp'd Ceiling I -- —� -- -- --- --
Roof
Other:
Final
PASS PART FAIL
UMBINC
-
Under Slab - --
Rough-In
Water Service
Sanitary Fewer
Rain Drains -
Catch Basin/Manhole
Storm Drain - -
Shower Pan
P _ PART FAIL
MECHANICAL_
Post& Beam'
Rough-In -
Gas Line
Smoke Dampers
Final
PASS PART FAIL - ---
ELECTRICAL
Service --
Rough-In -
UG/Slab - -
Low Voltage
Fire Alarm
Final Reinspection fee of required before next Inspection. Pay at Cly Hall, 13125 SW Hall Blvd.
PASS FART FAIL
SITE Please call for reinspection RE:_. __-_ -__ Unable to inspect-no access
Fire Supply line /
ADA
Approach/Sidewalk Date Inspector _ _ __- -Ext--
Other: _
Final DO NOT REMOVE th"mr. Inspection record from the job site.
PASS PARI' FAIL
CITY OF TIGARD PLUMBING PERMIT _
'' DEVELOPMENT SERVICES PERMIT#: PLM2004-00256
(I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/8/2004
SITE ADDRESS: 11620 SW LOMITA AVE PARCEL: 1S135DD-03620
SUBDIVISION: LOMITA TFRRACF ZONING: R-4.5
_—_ BLOCK: _ LOT: on � _ _ 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- 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES- OTHER FIXTURES:
TUBISHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Replace water heater in duplex unit addressed as 11600 SW Lomita Ave.
FEES
Owner: —
Description Date Amount
WANG, P;NG-JUI KAI
WANG,
93RD TER II'LUMB] I'cnnii Fec 6/8/2004 $7250
22,300 TUALATIN, OR 97062 l'(AX) 9'!4.Stale Surchar! 6!8/2004 $5.80
Total $78.30
Phone :
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone ' Final Inspection
Keg #:
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 tha 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
952-0001-0100. You may obtain copies of these rules or direct questions to OU NC by calling (503)
246-6699.
� _ Permittee Signature:
Issued By: � •�..C'�L
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
G
1Tlurti!��i�;1'_��'tt1i1"_gip �icalv►U
City of'Tigard P ived �p0
I-AtdBy Permit No
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rme"
Phone: 503.639.4191 Fax: 503.598.1960 Date/By ()thcr 11omrt No
24-Hour Inspection line: 503.639.419' nate Rewdvmv hats - ® Sei PaRe 2 rar -- ---
Internet: w'ww.ci.tigard.or.us M,tified; lcthod I supplrmrntnllnrormation
TYPE OF WORK FRE• SCHEDULE
❑New construction ❑I kmohtion - ___Haw special information use ehockUrt.
Addition/alteration/replacement — ❑Ocher New 1-2-fondly dwelllnp(includes 100 ft.for each utility connection)
CATRWRY OF CONSTRUCTION SFR(1)bath— _ 249.20
I-and 2-family dwelling ❑CommerciaHridustrial SFR(2)bath --- --_ 350.00 _-
❑Accessory building Multi-family ---_� SFR(3)bath 3".00 -
Each additionalluth/kitchen 45.00
Master builder Other -- -
❑
--- --- -- - -- _- fire sprinkler(_.—.sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION She utultles
Job site address: II Edo S!N_LaYY� Ac. -- Catch basin or area drain 16.60 _-
City/state/7.IP: r- D �3 IJrywcll.leach line.or trench drain -16.60
Suitc/bldg./apt.no.: Project name: i/ i _Fo drain(no.linear ft.:—) Page 2 _-
Cross street/directions to job site: ti Mar. turas home utilities 110.(x1
-- — -Mak"Aas 16.60
Ex-cm l A - $ qOR A Rain drain connector 16.60 - -
141K h et Saniluy sewer(no.linear Il.: ) Page 2
Storm sewer(no.linear R.:�) Page 2
Wer service(no.linen R.:
Subdivision: -OW"1 ��ce- — Lol no.
Fl
_�) Page 2 - --
' J 1-3 d. D 03 620 f - :lure or Mem
Tax map/parcel nn.: -- --- --
- --- Absorption valve 16.60
DR1111 IPTION OF WORK Backflow preventer Page 2 -
-k co Q c,wa^�e,(,= Backwater valve 16.60_
Clothes washer 16.60
Dishwasher 16.60
-
- -- - --- ._ - - - Drinking Gnrraain 16.60
- PROPERTY OWNER ❑ TENANT -
-- - ----- Ejectors/sump 16.60
Name: �- GlI7� Expansion tank 16.60
Address: -- — - —�_------- -._
as 6o C sw. '?3td Te*._ __ Fixnnelsewercap 16.60
City/State/71P: .- .100,t� q Ze 6 dJ -� ?l - Mom drain/floor sink/huh 16.60
._ _--
Phone:( 3 ►6 - �, �! Fax:(fit, )6 - 6 7 5 0 Iff Oarhage disposal 16.60
APPLICANT ONTACT PFRM14 Hose rib 16.60
C
---- Ice maker 16.60
Business name. -"---'—'�"---- --`-'--
-- -- -- - --- --- -----. -__ _-- Inlerceptorprcase trap 16.60
Confect name: A 5 k — Medical gas(value:S!► Page 2
Address: Primer _ 16.60
Cil} State/7.IP: ---- Root'drain(commercial)— - 16 60
- Sitdt/basirdlavatory Iii 60
Phone:( ) Fax ( ) ---- — -
-- - ---- Tub/showertshower pan 16.60
I'.-mail----- --_-- ----- (Irinal 16.60 -
CONTRACTOR _ _ Water elosel 1660
Business name - — Water heater — 16.60
Address: - tither. —
Citv/State/Z1P: --
Mir.:,uutn petmil fcc: 572.50 U
Phone:l ► -- Fax:( ► Residential baekr,rw minimurn-L
—
CCD Lic.: Tmil fce: $36,25
-� Plan review (25%of permit fee)
----_-"---- Plumbing I,ic.nn: _—_ _ -_
--- - - -
Authorized signature: State surcharge(8'h of permit fee)
�! — -- - -- �Q-
_ "ro'rnl.PERMI•f r•F.r•.
D o — — –
Print name: �� bale: 7- This permit appl{rtfer t has
If a accepted
t b not obtained within
_-�-_ _—_--_ ----__-.._. ,_. ._. 11M1 days after M has Leat accepted m rtmtpkte.
•1 cc method,dom set 1)%'I'ri-County Building Industry Service Board