Permit • CITY OF TIGARD PLUMBING PERMIT
� 90 r4. DEVELOPMENT SERVICES PERMIT #: PLM2000 -00130
'.�I DATE ISSUED: 5/11/00
13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12125 SW 69TH AVE PARCEL: 2S101AA -TTOOA
SUBDIVISION: TIGARD CORPORATE CENTER ZONING: MUE
BLOCK: LOT: OOA JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 15
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 200 ft
Remarks: By -pass vault, sand /oil separator, elev. sump pump, 8" deck drains for storm, and rain drains
FEES
Owner:
Type By Date Amount Receipt
SPECHT PROPERTIES PRMT DEB 5/11/00 $242.50 0002077
15400 SW MILLIKAN WAY PLCK DEB 5/11/00 $60.63 0002077
BEAVERTON, OR 97005 5PCT DEB 5/11/00 $19.40 0002077
Phone 1: 503 - 646 -2202 Total $322.53
Contractor:
MACDONALD MILLER OF OREGON INC
5711 SW HOOD
PORTLAND, OR 97201 REQUIRED INSPECTIONS
Phone 1: 230 -8991 Top -out Insp
Storm Drain Insp
Reg #: LIC 137340
PLM 37 -64PB Final
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 :
IEC , ���i ' . J �,.___ _k Per mittee Signature: K 14 „ LG4t�
C
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD Plumbing Permit Application Plan Che• , - 4 / gC
13125 SW HALL BLVD. Commercial and Residential Rec'd By'L ,
TIGARD, OR 97223 Date Rec'd -' -/ -o0
(503) 4394171 Date to P.E. L - Z 5 -
• Print or Type Date to DST 2
Incomplete or illegible applications will not be accepted Permit# - l?A)
0 \ ( Related SW #
fled 0 - 0-00
.0k, NrIGA
Name of Development/Project f//RK//U(r 6-471/)6e FIXTURES (individual) ) QTY PRICE AMT
Job / 6-4RQ CoRtableKTE CEArrEe Sink 11.50
Address Street Address /- Suite Lavatory 11.50
/2 / Z� =� , SW 69 Tub or Tub /Shower Comb. 11.50
Bldg # CitylState Zip p Shower Only 11.50
A T/6 -M `�
ZD Ot2_ �3 WaterCloset/Urinal (Specify) 11.50
Name
,®rOHf PleoP6PPES Dishwasher 11.50
Owner Mailing Address Suite Garbage Disposal 11.50
/S3 SW /n1GCIK4r- W ►9-y • Washing Machine/Laundry Tray (Specify) 11.50
City /State Zip Phone
QQ&Neero 0Z 9'7oc - (Oyto - 1202_, Floor Drain/Floor Sink 2" 11.50
Name 3" 11.50
g F_.J4 / sS ANI6 /lo co/ N L-f 4" 11.50
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 11.50
yyoo .g., / avc21oN - *US°,# 6 6 - /j(,, If Gas piping requires a separate mechanical permit.
City/State Zip Phone MFG Home New Water Service 28.00
WAVE21 02 97005 2.9A - 83oe MFG Home New San/Storm Sewer 28.00
Name Hose Bibs 11.50
/h9 • - fl/ZGEiC
Contractor Mailing Address Suite Rain Drains .z 11.50 0 ,U
c 7 I L :SO F{ Oo0 Drinking Fountain 11.50
Prior to permit City/State Zip Phone Other Fixtures (Specify) 15.00
issuance, a copy. ebleTC.io1 OR Q ? 7-01 ZpQ - g9 9 I
of all licenses are Oregon Const. Cont. Board Uc.# Exp. Date & t P A-ss u oac..T 1 11,3 t/ 56
required if 1 3 - 7 3 4 0 61 Z7_103 SIAN 0 ibi t. SE rAgAva, 1 )/.56 it,-00
expired in COT Plumbing Lic. # Exp. Date E V . Sean -.P PuorrP 1 A S§ / /r
database 3 64 Pg glt bEC-44._ W2tMtJS'�STorz-vx• 10 Mr- 11_5
Name Sewer - 1st 100' 38.00
Architect L Ks IA- (.u-t tTec, S Sewer - each additional 100' 32.00 .
Or Mailing Address Suite Water Service - 1st 100' 38.00
112- \ `510 SAL rno i0 Water Service - each additional 200' 32.00
Engineer City/State Zip Phone
9 P 0 2 1 1 A - 630 OE. Ch2.ds ZZI -( (Z\ Storm & Rain Drain -1st 100' I 38.00 a8 ov
Describe work to be done: Storm & Rain Drain - each additional 100' I 32.00 , ,
New • Repair 0 Replace with like kind: Yes 0 No • Commercial Back Flow Prevention Device 32.00
Residential 0 Commercial 0 Residential Backflow Prevention Device' 19.00
Additional description of work:
Catch Basin 11.50
Insp. of Existing Plumbing 50.00
Are you capping, moving or replacing any fixtures? per/hr
Yes 0 No • Specially Requested Inspections 50.00
If yes, see back of form to indicate work performed by per/hr
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain, single family dwelling 45.00
WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50
I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL
given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram ir.. required if Quantity Total is > 9 _ •
that plans submitted are in compliance with Oregon State Laws. *SUBTOTAL �1
SI n l ure of Own er /Ase t / ' / Date / o�7d+
i>A�.... ,h,r VP? too g% plirgriRCHARGE /? •
Contact Person Name Phone
,e /1'N m/T'_J/ a Z- 230 579/ *"PLAN REVIEW 25% OF SUBTOTAL * 4'5
-1 BATHHOUSE 07100 - - Required only if fixture qty. total is > 9 .
�.2 BATH NOUSE $250.00 , TOTAL - f "53
-1 B .tH HOUSE $285.00 ' - . ' , x'0105
Irk* fee includes all plumbing flXtures iii 'the dwelling and the first
BOO Afiaratti- �eW StOrrn.SAWer and waterseryIc8) .' 'Mtnlmum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention
Device, which is $25 + 7% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram and
n/� /� plan review.
I:WstsVxumslptumapp.doc 7 /19199
g V l I /J�/an, 0 062- 1 -
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
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain /Floor Sink 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
•
1: 1dslsl1ormsVlumapp.doc 7 /19/99
CITY OF TIGARD BUILDING INSPECTIOND_IVISION MST
24 -Hour Inspection Line: 639 -4175 '` Busines - 639 - 4171
t • - .: BUP
Date Requested (0 1 (/O ! AM PM
BLD
Location - 1-7.i 2 C ( >7 q Suite MEC
Contact Person I /14 Ph `I ' TL 2 PLM on() ° 00i*
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing - '.y-.1 - `,�Y;, r i'i! { ; «i1 v•�.- �a�•.. �Y .....�.. .�`'
-S. :\'��. _ a� s1 'S�:A 'L...: ^ � � wS..T.- '• -ati' 'KO "�.
Foundation it �Yni" "'ti '
. . FPS
C i' ` � } r' �t. ►�� ,�: nc �F7 s� .r�yw��
Ftg Drain __�f:.�>:.Q•�. •.•: y < '� ' �ti't�.zL,:��r • '�
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof /
Misc: �. v
Final
PASS PART FAIL
L- IBING'�
eam
rjder 91a -
Top0ei
Water Service
Sanitary Sewer
Rain Drains
Final
4 — b 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
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 / i 7) a2
Other Date Inspector , Ext
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 •
BUP
Date Requested % AM PM BLD
Location /24 (9 q i� Suite MEC
Contact Person
TI Ph( 3)�?,� 2 SD7 PLM v)06-0 3 (3
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: ' " ,,,� FPS
A
Ft
Foundation 14i5 ( 5549 JAS iT OA C °c.0.74 9e���U�G
Crawl Drain Inspection NotesVo t�2 ryt ptz l S hvf- r e.kt je ST
Slab
Post & Beam 1 6/S p ri
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
tiMMI
Prat R,
nder SIa
Top Out
Water Service
Sanitary Sewer
Rain Drains
Fin,
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
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 / � 1
Other Inspector --- Ext
Final
PASS PART FAIL I 0 NOT REMOVE this inspection record from the job site.