Permit 04/21/2000 Activities for Case #: PLM1999 -00416
2:34:30 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 11/29/1999 KJP RECD No Hold KJP 12/08/1999
PLMC005 Permit Created 12/08/1999 KJP DONE No Hold KJP 12/08/1999
PLMC710 Water Line lnsp 12/08/1999 12/08/1999 No Hold KJP 12/08/1999
PLMC725 Top -out Insp 12/08/1999 12/08/1999 01/18/2000 MRS PASS No Hold AKJ 01/18/2000 where does sink line terminate
PLMC799 Final Inspection 12/08/1999 12/08/1999 No Hold KJP 12/14/1999 Customer states he has 12
previous fixtures all to be
capped. Mike Sheenan will do
count at inspection. If count is
incorrect we will need to do a
new sewer tally count.
Customer is aware of this.
PLMC040 (F) Ready to issue 12/08/1999 KJP DONE No Hold KJP 12/08/1999
PLMCO50 (F) Issue permit 12/16/1999 GEO DONE No Hold DST 12/16/1999
PLMC799 Final Inspection 02/23/2000 02/23/2000 02/23/2000 TLP PASS No Hold AKJ 02/23/2000
PLMC800 Case Fineled 02/23/2000 AKJ DONE No Hold AKJ 02/23/2000
e
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Page 1 of 1
CITY TIGARD PLUMBING PERMIT
PERMIT #: PLM1999 -00416
' r ! DEVELOPMENT SERVICES DATE ISSUED: 12/16/1999
`�" 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171
SITE ADDRESS: 11705 SW 68TH AVE PARCEL: 1S136DD -02600
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING:
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 3 URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: 100 ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Remove 2 sinks, 1 water closet, and 1 water heater. Install 3 new sinks, 2 water closets, 1 dishwasher, 1 water
heater, and water service - 1st 100 ft. SWR1999- 00260.
FEES
Owner:
Type By Date Amount Receipt
DEAN SMITH PRMT DST 12/16/199E. $118.50 99- 320478
SMITH, JO ANN MONDELLI TRS SPOT DST 12/16/199E $9.48 99- 320478
17880 SARAH HILL LN
LAKE OSWEGO, OR 97035 Total $127.98
Phone 1:
Contractor:
ROCK CONSTRUCTION + PLUMBING
P 0 BOX 8507
BEND, OR 97708 REQUIRED INSPECTIONS
Phone 1: 541 - 317 -2944 Water Line Insp
Reg #: LIC 00112770 Fop -out Insp
PLM 9 -184PB Final Inspection
ORIGINAL
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 -0080.
You may obtain copies of ese rules or direct questions to OUNC by calling (503) 246 -1987.
/r
Issued By: , / /� Permittee Signature:
Call (503) •39 -4175 by 7:00 P.M. for an inspection needed the next business day
•
"' ` /� Sewer Tally
Tenant Name: 61 1 0 -A v- i 1 �t s V rcu-t-t G t ' i C'. cii 1(7 e r f This SWR# Se,-)P / i Go 2 - (o C
Address: 117o 5 S b i -' This PLM #: PL/C4 / l'9 - 00 `1 /sa
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# - Value Capped off value added # added ads total
Count . off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4 , -
- Jacuzzi/Whirlpool 4 -
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4 b I�- ���3 y
- Domestic 2 1 - r rr I � K - r
Drinking Fountain 1 .
• Eye Wash 1
Floor Drain/sink - 2 inch 2 •
- 3 inch 5
- 4 inch 6
- Car Wash Drn 6 ,
Garbage-Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48 -
Ice Machine/Refrigerator Drains 1 -
Oil Sep -(Gas Station) 6 `
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar/Lavatory 2 -
- Bradley 5 q
- Commercial • 3 .2 tP 3
- Service 3 .
Swimming Pool Filter 1 _ -
Washer - Clothes 6 • -
Water Extractor 6 /
Water Closet - Toilet 6 1 le ° 1 L
Urinal 6
. — 3 --II 6, 2.3 z3
TOTALS
Total fixture values: 23 divided by 16 = 1, Li il EDU NO c ` ck^^x- /
HISTORY QR.q 4 t�. . � 44 57 �rej cam' j'1 I'2.. � t� - (.. .J' Ed i 1 k . e (:_r fa.e' ,
PLM# EDU# I a_ SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
Odstslswftaly.doc nr! ! +' j".. 1)-...4.A. r `.•n'; % °. r IF' r.e_
o i LtI -° �c� • "1 4 co-f 4'e e cu, f5 04 / y , O K -it (A.ip /o? 4'1 y7744 /L,. (.) 1 1 / cflp C o ,.,� 2-i- f •.sIOeci c
CITY OF TIGARD Plumbing Permit Application Plan C
1312 SW HALL BLVD. Commercial and Residential Rec'd B •
'TIGARD, OR 97223 1 Date Rec'd // - -027
(503) 639 -4171 /" j 1 Date to P.E.
Print or Type
Date to DST
Inco plete or illegible applications will not be accepted Permit# PIM0 e� ' 6(6
Related S #) c frig?-0j
6,, � 1 R _ 00 -7 Called /X1 r/ f%-- ttA
,
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job Aoki h / 'cf i c Na6/,) t4 r Sink 3 v 11.50 505-e...) Address Street Address cc ,..� Su' e . Lavatory 11.50
Il T oe J lam) (J P .„,, Tub or Tub /S Comb. 11.50
.
Bldg j estate n iP �., Shower Only 11.50
t 1T1�- - 1 / Water Closet/Urinal (Specify) Ai, 11.50 a3 .0 0
Na
tI L u l• • -./ Dishwasher t 11.50 /0• 50
Owner Mailing Address , uite Urinal 11.50
/788b S l a•,. ::v . .r
• a � Garbage Disposal 11.50
3 a ..o-A Ii1 Ci mate Zip Phone Laundry Tray 11.50
11.QkC. QSu+eAe -•4*--
q p 3S Name • � ' i i f. acki,: a Washing Machine/Laundry Tray (Specify) 11.50
Floor Drain/Floor Sink 2" 11.50
Occupant Mailing Address f�v� Suite 3" 11.50
(1 wo5 c,-u3 4" 11.50
Ci /State Zip Phone
. 1 �� � Water Heater 0 conversion like kind / 11.50 /�, 5C)
Cl� IQ � Gas piping requires a separate mechanical permit.
Na = � MFG Home New Water Service 28.00
Contractor Maili Address Suite MFG Home New San/Storm Sewer 28.00
VQ (.5 Hose Bibs 11.50
Prior to permit C'ty /State Zip P o Roof Drains 11.50
issuance, a copy Q, (l_ MO2 (54T1 _ g Drinking Fountain 11.50
of all licenses are Ore nst Cont. Board Lic.# p �/
required if / 7 7 , I . 00 Other Fixtures (Specify) 15.00
expired in COT Plumlvng y ,. te
database f - y§,/ T I r /RY! ° 0
Name
Architect ,,ns Sewer- 1st 100' 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
IX�O �JU�)al�zr\ 5 . Water Service - 1st 100' . A 38.00 4r5ie 0
Engineer /Sttale a i� Zip l o`I�a Phone -- Q 1 ( Water Service - each additional 200' - 32.00
�1l�Cjj
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 0 Repla with like kind: Yes* No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial
Additional description of work: \ �,,�(,,,��a Commercial Back Flow Prevention Device 32.00
/ \ �S 1 Catch Basin Backflow Prevention Device' 19.00
(` � J l JJ Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Ye No 0 Inspections per/hr
If yes, see back o o to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL A
!hereby acknowledge that I have read this application, that the information isometric or riser diagram is required if Quantity Total is s > 9 i
given ' co ect, that I am the owner or authorized agent of the owner, and - p
tha i ns ubmitted are in compli with Oregon State Laws. *SUBTOTAL / 1 .`5
`t i atur of Owner /Agent Dat 8% SURCHARGE
.„."-il Il zill 9 C to t Person Name P one
A/ r) (T rt/ e y • _,6Z5/_7/ 0-0 **PLAN REVIEW 25% OF SUBTOTAL
1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9 • 2 BATH HOUSE $250.00 * ' TOTAL /e27 -1e
. 3 BATH HOUSE $285.00 - •r �
{This fee Includes all plumbing-fixtures In the dwelling and the first *Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention •
100 feet of sanitary stone sewer and water service) 7 Device, which is $25 + 8% surcharge
**All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
l:tdstsVormslplumapp.doc 10/1/99 -
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved I Replaced Removed /Capped
Sink -�
Lavatory
Tub or Tub /Shower Combination
Shower Only ,
Water Closet o ? 4
Dishwasher
Urinal
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
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I:WstsWormskplumapp.doc 10/1/99 - . -
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
7/
Date Requested 1 2 �j AM PM BLD
Location I /�v S 1�� /// Suite MEC
Contact Person eC: _/ Ph SO 3 -77, 7& / 799
-oO N/
Contractor Ph SWR
BUILDING Tenant/OwneE ) t * E ( 3 ! ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear �
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Ina Sheath /Shear �' a
Framing - _ f "`" -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
•J , BIN
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
4i _
` PART FAIL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough 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 Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Z /73 / � J ( J Inspector Ext
Other Ti°11
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.