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Permit CITY TIGARD PLUMBING PERMIT ,Q r� DEVELOPMENT SERVICES PE DEVELOPMENT PLM2000 -00128 ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/11/00 SITE ADDRESS: 12259 SW 69TH AVE PARCEL: 2S101AA -09100 SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 030 JURISDICTION: TIG CLASS OF WORK: ALT. GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS; 10 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 7 URINALS: 2 GREASE TRAPS: 1 LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: 1 RAIN DRAIN: ft Remarks: Plumbing TI FEES Owner: Type By Date Amount Receipt SPECHT PROPERTIES PRMT DEB 5/11/00 $276.00 0002077 15400 SW MILLIKAN WAY PLCK DEB 5/11/00 $69.00 0002077 BEAVERTON, OR 97006 5PCT DEB 5/11/00 $22.08 0002077 Total $367.08 Phone 1: Contractor: MACDONALD MILLER OF OREGON INC 5711 SW HOOD PORTLAND, OR 97201 REQUIRED INSPECTIONS Underfloor /Underslab Phone 1: 230 -8991 Top -out Insp 7` Reg #: LIC 137340 Final Inspection' PLM 37 -64PB • OR‘GNN • 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 B r .• � • _ • i• ;_, Permittee Signature: e„c..,= // Gib CaII (503) 639 -4175 by 7 :00 P.M. for an inspection needed the next business day CITY OF TIGARD . • li Plumbing Permit Application Plan the 13125 SW HALL BLVD. Commercial and Residential Recd B TIGARD, OR 97223 Date Rec'd Date to P.E. _/ a_ (503) 639 -4171 Date to DST '� Print or Type Permit# f �' / a7 Incomplete or illegible applications will not be accepted Related SWR# 6 C - as 8 3 Q�jj .S % 1-eo 0- 2poL, W/ Aric A, Pi . Name of Development/Project FIXTURES (individual) . QTY PRICE AMT Job 1'ILvi ftri ld/L)oD•r,-. c�Erli jt� Sink -J 11.50 Qp, 3G • e Lavatory 11.50 S treet Address I Suit 0 Address f l?.Z59 SW 61 114. � 477 Tub or Tub /Shower Comb. 11.50 Bldg # City /State Zip Shower Only 11.50 - Tn. OK* ( Qt '11 ZZ Water Closet 'Z 11.50 p.` Name Z .11. �' �' 5PEc . - ettoPovn aS Urinal r) ' Owner Mailing Address Suite Dishwasher j 11.50 /00 ISyeb 5W el h l4 /'•rw) WW1 Garbage Disposal 11.50 City /State Zip Phone Laundry Tray 11.50 ��,�" 9700 G b!{L�Z2o't_ Washing Machine/Laundry Tray 11.50 Name an`30 IS� E•�L.b1INV- , 114 L Floor Drain/Floor Sink 2" / 3 11.50 5c1. {°© Occupant " Mailing Address Suite 3" / , 11.50 qO.5./` 9N00 SW i3eAtlertati -j u4c4'LF twill 4" 11.50 City/State , Phone Water Heater O conversion O like kind I // 11.50 1/ti�� �' 17005 Z9'5 -5 Gas piping requires a separate mechanical permit. / ' ° Name MFG Home New Water Service 32.00 MI�i�D������ MFG Home New San/Storm Sewer 32.00 Contractor Mailing Address Suite GI)/ � 1-loo f Hose Bibs 11.50 Prior to permit /State Zip Phone Roof Drains 11.50 issuance, a copy im , d17II 7.- O -ell/ Drinking Fountain 11.50 of all are ((311n; t�Cont. Board Lic.# Exp. DatS required lred'rf V f', Zz v3 Other Fixtures (Specify) 15.00 expired in COT PIyinbin L c. 5 Exp. Date database 5 & if Name Architect L AIZeifi ,"5 Sewer -1st 100' 38.00 or Mailing Address ,� 1 Suite Sewer - each additional 100' 32.00 /Z/ St..) ti f LAID "- Water Service - 1st 100' 38 - Engineer State Zig Phone Water Service - each additional 200' 32.00 I �LT1�Mj0� `� 72DS ZS/ - 1 12�� Storm & Rain Drain - 1st 100' 38.00 Describe work to be done: New Ap - Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00 Residential 0 Commercial a Commercial Back Flow Prevention Device . 32.00 Additional description of work: Residential Backflow Prevention Device* 19.00 Catch Basin 11.50 Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 Yes • No 0 Inspections 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 s I 11.50 /i („,-; WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required If Quantity Total is > 9 given is correct, that D am the owner or authorized agent of the owner, and *SUBTOTAL OO that plans submitted are in co Hance with Oregon State Laws. Si re Ow Age` /, D?f Z � /� 8% SURCHARGE 08 matt Persop N♦a�m/e Phone "PLAN REVIEW 25% OF SUBTOTAL /,, /b/ A pf . Required only If fixture qty. total is > 9 W 9' D pf HOUSE $'178,00 -• :r w TOTAL a � ' opsE;2ii0itr .,a , +� ..1... '; } b / 0 , 08 .; s -, OI�SE;;6285f10 . S x b r ri k y, . s r `3 a . s t r • s .t . apes ,IMUTbing res nAte dwelling �d,#he rstC y n '; *Minimum permit fee is 950 + 8% surcharge, except Residential Backflow Prevention . , , w sewers • r8t1 , 861VICe .''.'A-.:: - ew c Commercial Buildings rrequke plans with isometric or riser diagram and plan review. r:ldstsVorrnslph+mapp.doc 11/18/99 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 Urinal ,7 Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Floor Sink 2" 3 3" 7 4" Water Heater Other Fixtures (Specify) INArtoet - Gc9LE Z — 1 7 COMMENTS REGARDING ABOVE: • 1: ldstsvormslplumapp.doe 11/18/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested CI 3/1 ) 400 AM tlC I/ PM BLD Location (7i Z Sq iO ! �' "l Suite MEC Contact Person _ IX S '" Ph 4 1 Z? - 2S6 PLM 1ZOO -on/ ag Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear \ Int Sheath /Shear 7'0ac/T Framing _ a r Insulation �° ��OD /�!q i - / /w Ve 0 +.eX.1 Drywall Nailing Firewall Fire Sprinkler d �' Fire Alarm / ,J' T�i '-' 5- D • Susp'd Ceiling Roof Misc: Final - PASS ' RT FAIL ..10 . Water Service Sanitary Sewer Rain Drains Fi - 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 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 0 l / Approach /Sidewalk Other Date 0 /7 a v Inspector / t Ext =: Final PASS PART 1` FAIL DO NOT 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 41/09 AM PM BLD Location 1 2_7,sq ll! Suite MEC Contact Person ma 4-4- Ph 1 4 3'2 -ZS b7 PLM 'WV Z Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain 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: Final PASS RT FAIL P UMBIN) Post S Beam Under Slab T•p Ou - Service Sanitary Sewer Rain Drains F es' /. • _ FAIL HA Post & Beam Rough n Smoke Dampers Fi 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 qi Inspector � �� Ext Other I PART FAIL DO NOT REMOVE this inspection record from the job site.