11810 SW LYNN STREET I
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11810 SW Lynn Strest
CITYOF TIGARD —._PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: FLM2002-00371
2.6 FML 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/19/02
SITE ADDRESS: 11810 SW LYNN ST PARCEL: "'i103'.3A-00135
SUBDIVISIGN: LERON HEIGHTS NO. 2 ZONING: R-4.5
�^ BLOCKS _ LOT: 025 --------------JURISDICTION: TIG
CLASS OF WORK: A[T GARBAGE DISPOSALS: MOBILE NOME SPACES:
TYPE OF uSE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: NATER HE=ATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWEr LINE: ft
WATER CL[)SETS: WATER LINE: 40 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Water Service
FEES
Owner: _ _�_--
SPENCER, MELVIN D Type By Date — Amount Receipt
11810 SW LINN PRMT CTR 9/19/0? $72.50 27200200000
TIGARD, OR 97223 5PCT CTR 9/19/02 $5.80 27200207000
Total $78.30
Phone 1:
Contractor:
JACK HOWK PLUMBING
1910 NW BURNSIDE
PORTLAND, OR 97030
REQUIRED INSPECTIONS
Phor- 1: 235-8784 Water Service Insp
Reg#: LIC 146779
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 lags. All work will he 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 Canter. Thoso rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtF,n copies of thetie rules or direct questions to OUNC by calling ("J3) 246-1987.
Issued By: ` , ") �� Permittee Signature: 7t
..all (SCJ) 639-4175 by i':00 P.M. for an inspection needed the next busine s. ay
SEP. 12.200," 5:17PM JACK_HOWK PLJMBII i1 l i''•r l i l
1
f Plumbing PermitApplication
~— Uafect ceivcd I'errot—In
o.: C
City of i agwd Sower PVtmit no.: I' pit ng prrtnit no.: -�
Addimss: 13125 SW J-tell Blvd,Tlgaru,OR 97223 i'rujecJeppl.no.: Expire date:
(;iry of rigarld phone; (503) 6139.4171 --
F'aa: (503)598-1%0 Date issued: - ley: Ruelp(no-:�-
• Case file nn.: Payment type.
Land use approval:M --•.-a--
TI 1-2 fttmily dwelling nr accC.saory CtitAml 4Zu1 0 Multi-family i7'fc;,,;.impmvcm�n1-
U Now onstruction �J Addition/ lE�atipp/roplecemeut U Food a�.rvicc C)Other. _
Descxf Boo (�h. Fec(c�. 7otx1
Joh address:
Nldg.nv,; __—�Sufteuo.: `_ ^_ - (Indudaol00�1.forev��trr➢111ycunnetitlod)
Tay,map/ttix lou_;,ccount no_.: SFlt(1)bath -- -- - - - - --
I of Blocker TSubdiviaion: Solt(2(2)Uath _
th
Project name: -' S(rFtZa) _ �--
Eachoddit on it►h/kitchen
Site Andes:
City/coon�.r..� _ .�--�-�•u�
~Msotiritiool c qfvrork nn rrdsCs: "��„�. --- Cutch hasinhuea dtain_M
_ rTr --
- Urywe Is/leac line trench drain
Ei4L dxtb of completion/ina coon: Irootiq drain(no,lb).ft.) -
aoufacn_ hvrne utilities
Ruoinev,,mane: toles -- -- - -
R.un min connvcthn
t Stnlc: ::IP: Zu_�- Sanitary st*wer(no.li_n. R.) _
C fty: fUJ L1 ''� r Sturm Sewer(nu.lin.ft.)
Phono! 3 - ° Fax: �� R-mail; ate"s
' crvict act. in.
}'lurnh.huv,re 11 '� r
g' 0:e-•.-.-- � =�a {Fyxture or Item:
City/motto lie.no..41 _.r -- Alt ition valve
Cnntneclor's rp rencniallve 3i nn`t1m: 12 L �`vaO1t' ---- -
Pnnt name:—'r' ) G �l.t' iL: ll�tr. Dackwntrr v ve --•- --—a----
Banin lavatory
Clothes wmttrr
Ad_dtr..rA;
State=-. V,IP:
Fltone: 1'nz: E-meil: panaun _--
txtuwAcwer ca -
lcloor dn:lnelflrmr sinks/tiub �
Name(print):
Mailing address: F ose bihb — _ -- --. --�
—_.
Ci
Stale, Jp': 77 maker
Phone: F=ax: I:rnpil: aicaccptor/�rcesc trap
1�vnNr insvdl�tionfresldt ntur' maiwenance only; The actual Installntion Prirner(s) _ w_
witi he made by me or the mtuntenancr and terah made by my regular Roof drain(eommereial)
omployee ors the property I num as per ORS Cliaptar 447. i 1-e);bbisin(s ,tavt;( -
owner's signature:__ Date; _ -- -TU—MD -- - - —
Tuhe/shower/ebower pan
Urinal_..—_-
Name: _ Water f'osel -
Addre-sx -- _.. -Vater heater -- -. -
City: 3tatc �1I�IP: — tJther
Mane
r '_.� E_tt�1; Total +Lo
f,4hirnum fee................$
Notice 'Mis parmit appllcetint, 1'Inr review(at -- %) S ..
expires ite permit to notuutained c-.
within IRO days eller it ha?been Strtc sumharpc(8%) ....!
accepted ee complete. -101 AL .......................$ �-
"(1-4616 fH AlCr,M l
CITY OF: TIGARD 24-Hour
BU',LDIIJG Inspection Line: (503) 639-4175
MST
INSPECTION DIW30ION Business Line: (503)639-4171
>� BUP -- -
Received _-__ D��e RequestEd -_----��11�_ AM - --- PM BLIP
Location 1�� 'Z't-iYf-J ^_Suite _ MEC
Contact Person Ph( ) , ..�z�' 79� PLICA
Contractor _ Ph( ) SVOR
BUILDING Tenant/Owner _ - ELC
Footing
Foundation ELC
Acce..s..
Ftg Drain ELR
Crawl Drain
Slab !nspection Notes: - SIT -
�' Beam
Silo ,- Anchors -
L.a aheath/Shear
Int ShAath/Shear
Framing --
Insulation
Drywall Nailing - - -
Firewall /
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -- --- --- --- -
Root
Other:
Final _ —T-
_PASS PART FAIL
- - -- -
PLUMBING
-Post& Beam -
Under Slab
Rough-In
Vater5ervicb- G' - - — - -- -
San 0r-y ewer
Rain Drains -_-
Catch Basin/Manhole
Storm Drain - —
Shower Pan
Other:
AS 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 Reinspection fee of$_ _ required before next inspection. Pay at City Nall, 13125 SW Hall Blvd.
PASS PART FAIL
SITEl] Please call for reinspection RE:_ ____- __ [] Unable to inspect-no access
Fire Supply Line �f /
ADA Date l L Inspector_ -- Ext
Approach/Sidewalk --
Other:
Find DO NOT REMOVE this Inspectio record from the job site.
PASS PART FAIL