Permit C ITY OF TIGARD PLUMBING PERMIT
yip DEVELOPMENT SERVICES PERMIT #: PLM1999 -00394
„-i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/22/1999
SITE ADDRESS: 12123 SW 69TH AVE PARCEL: 2S101AA -TTOOA
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOA JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: 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: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Install commercial back flow prevention device.
FEES
Owner:
Type By Date Amount Receipt
TIGARD CORPORATE CENTER LP PRMT KJP 11/22/199£ $50.00 99- 319956
15400 SW MILLIK 5PCT KJP 11/22/199£ $4.00 99- 319956
9
BEAVERTON, OR 97006
Total $54.00
Phone 1:
Contractor:
NORTHWEST LANDSCAPE INDUSTRIES
16075 SW UPPER BOONES FERRY RD
TIGARD, OR 97224 REQUIRED INSPECTIONS
Phone 1: 684 -1450 RP /Backflow Preventer
Reg #: LIC 7030E Final Inspection
ORIGINAI
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 these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: `7'!'7 G J
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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ii8a -d Culpn a . ooST _
CITY OF_ TIGARD RECEIVED Plumbing Permit Application - PIS, *
13125 SW HALL BLVD. Commercial and Residential Recd By
TIGARD, OR 97223 NOV 19 1999 Date Rec'd
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
COMMUNIU DEVE
ncom plete o r illegible applications will not be accepted Permft # ?lied I9 9 - uu y .
Related SWR a
Called
Na of Developp //�. L , -� ;- - r"_ °_ __
1 ! � I.X f � � t � /V U Q i / V �..:.�: J... ���u',.,.y'•y3 �Ti6C� � �= - ..e ?ES'�,�'t )� - �y_- c a »: .rr.: ; �535:��"�i+."
4:.... :T y f�Y..:.
Job ,• , 11.50 •
Address S Address Suite Lavatory 11.50 .
1 & 1 a 3 SW 4.Sul Tub or Tub/Shower Comb. 11.50 -
• Bldg * Cit Shower Oniy 11.50
'Tl C;A C/1612 4 2-23
Water Closet/Urinal (Specify) 11.50
Name ,p
iqc A ecrIc ct. t, e n,. Dishwasher • 11.50
Owner f ail�i Address Sum Urinal 11.50
r c l a s s W �I IKt U< Garbage Disposal - 11.50
( [ /State , o R -9 Phone
Z.Z 3 Laundry Tray 11.50
Name • Wang Machine/Laundry Tray (Specify) 11.50
Toci.Ari (e r tiotn Gk. e,� Floor Drain/Floor Sink 7 11.50
Occupant
122s- smut a W � ��C Suite 3' 11.50
City/State Zip Phone 4' 11.50
0 4 2.3 Water Heater 0 conversion 0 Ile kind 11.50
Q ct 1.. Gas piping requires e separate mechanical permit
Nn►tGiwes+ i,cu/�dsc •e TYtd litA a.o MFG Home New Water Service 28.00
Contractor Mailing Address MFG Home New San/Storm Sewer 28.00
/46 W iC IT\( Rci. Hose Bibs - 11.50 Phone . •
Prior Roof Drains 11.50
Issuance. pemlit a copy Ti i ?wet, OR 97 za Li , g q • I NS Drtrddng Fountain 11.50
of all des are Oregon ConsL Cont Board Lk.* 6x.pat r✓
requir if - 703 t7 411.4610
, r Ftaures (Specify) 15.00
e> database Pwmbirlg s0 8 W 2b /0o t ,
Name p ct 11 [L,_
Architect L R. S ilm9�.II Sewer -1st 100' 38.00
or ! Mailing Ads W c A� Q o Sewer - each additional 100' 32.00
Engineer lty/state ZIP Phone Water Service -1st 100' 38.00
/IA-004d t OR C l 7 2 0 5 Water Service - each additional 200' • 32.00
Desatbe work to be done: Storm 8 Rain Drain - 1st 100' 38.00
New jk Repair O Replace with Re kind: Yes 0 No 0 Stoma & Rain Drain- each additional 100 32.00
Residential O Commercial Commercial Back Row Prevention Device ' 32.00 30:
Addition I ,d�,e�saiptii�o►n of work: ��T R Badcflow Prevention Device' 19.00
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"" "� `- "�`'r'� X71 T Catch Basin 11.50
Are you capping, Yes moving ing or replacing any fixtures? Insp. of F Plumbing or Specially Requested 50.00
nspections per/hr
If yes, see back of form 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 i;- °= -=
` =. , i ;?';;_;;
I hereby acknowledge that I have read this application, that the information
i: : = ,
given Is correct that I am the owner or authorized agent of the owner. and Isometric or riser diagram is required if Quarddy Total is > 9 i t ` -:- -.:
that plans submitted al: n compliance with Oregon State Laws. *SUBTOTAL -'`1 _s . -
Sign: • .. at p 8 °k SURCHARGE - `'� •'
I
g , Agent D I.- ( - == r i "_ -- = 1 1,00
on Name ( P o
� 1' - / • R - - 5 c� (ys * 'PLAN REVIEW 25% OF SUBTOTAL _ =_ - _ ``�'N' '
rt = l i _ , - ! L PaP'iri P}7.�y°�pry ; ;3 Required ord if fixture qty. total is > 9 = - - _ �.
i t f _ -rr S'A�' LiP'1~I t •'O�e-:1'.... _ - _- - -
. �, .x: �• :_ �, -- / TOTAL ;!
_ :"- _
tt4,0 ,- : h [ r,,.. � _ ".: 'Minimum permRfee 450 +897; h except Residential Backibw P -
�:`� - - � l �::l:; t•.c . :� � •, � _. . - " " k� � - Device, which ls=25a994surcharge •
- All New Commercial Buildings require plans with Isometric or riser diagram and
plan review.
l:ldsts1tormMplumapp.doc 1011/99
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639-4171
BUP
Date Requested X/..C/C AM PM BLD
Location /2 2i (t0 �`-Tl / ' . Suite �y MEC
Contact Person Ph C0 k_4 1 q q
Contractor Ph SWR
BUILDING Tenant/Owner — ELC
Retaining Wall ELR
Footing A NOT REQUESTED FPS
Foundation FOUND DURING RESEARCH
Ftg Drain NO INSPECTION (s) IN FILE SGN
Crawl Drain Ir )
Slab SIT
Post & Beam (�
Ext Sheath /Shear P I O btSB
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 5 G1 Roof
Misc:
Final
P T FAIL
LUMBING
Post & Beam
Under Slab w �
Top Out
Water Service 'AXE* � WAI11172'
Sanitary Sewer '
Rain Drains F PART FAIL 1, / �r , / �I �/ Pr
/�
ANICAL
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
72,1 Approach /Sidewalk Date Inspector Ex t _
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.