Permit CITY OF TIGARD PLUMBING PERMIT
``a r DEVELOPMENT SERVICES PERMIT #: PLM1999 -00217
� � 1 p \ DATE ISSUED: 8/25/99
-= 13125 SW Hall Blvd., Tigard, OR 972 1 (50 1f �` {y 1.. SITE ADDRESS: 12559 SW 69TH AVE jj v 1 t PARCEL: 2S101AA -09108
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 030 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: B FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: 100 ft
DISHWASHERS: 1 RAIN DRAIN: 100 ft
Remarks: Plumbing work for new office building. Sewer permit #SWR98- 000120, add 1 to the current EDU of 8 = 9.
FEES
Owner:
Type By Date Amount Receipt
PORTER, DENISE/ BENNETT, SUE PRMT DEB 8/25/99 $226.50 99- 317935
7991 SW MOHAWK ST PLCK DEB 8/25/99 $56.63 99- 317935
TUALATIN, OR 97062 5PCT DEB 8/25/99 $15.86 99- 317935
Phone 1: Total $298.99
Contractor:
PREMIER PLUMBING
17576 SW FARMINGTON
STE 443 REQUIRED INSPECTIONS
ALOHA, OR 97007
Phone 1: 642 -7868 Water Service Insp
# : LIC 124547 Top -out Insp
Reg Storm Drain Insp
PLM 34 -318PB Rain Drain Insp
RP /Backflow Preventer
Final Inspection
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 obtain c pies of these rules or direct questions to OUNC b - ing (503) 246 -1987.
Iss ed By: i .0„ 7, �ti� �' Permittee Signat , �-�� " ,
&
CaII (50339 -4175 by 7:00 P.M. for an inspection needed the next business day `'
CITY OF TIGARD Plumbing Permit Application Plan Check • 7
13125 SW HALL BLVD. Commercial and Residential Rec'd By o f ,
TIGARD, OR 97223 Date Rec'd -' ii
(503) 639 -4171 Date to P.E. 7 - /6. - •
'rint,or Type Date to DST
• 1, Incomplete or illegibteapplications will not be accepted Related S1NR # 5 0 )e98 00
•
Called 7 30-1 -Q-
99o,<E cJ /4* V:/Ssdir
Name of Development/Project FIXTURES (individual) - QTY PRICE AMT
• Job ,e1INA /f �j / /o/Z/e /L I` f 5S0 Sink /- " 11.50 // 5r}
Address Street Address / Suite Lavatory 3 ✓ 11.50 3e/iv
/2S,S11 ro , Sid ?five- _ Tub or Tub /Shower Comb. 11.50
Bldg # City/State Zip Shower Only 11.50
Name . n(-714/2D � _ 7 722 Water Water Closet 3 -, 11.50 3 9 5C
A t SQ f x k r / ` ^ g241 /et1 Dishwasher 1 • ✓ 11.50 / / .5 v
Owner Mailing Address Suite Garbage Disposal 11.50
�9 I �LV {' ��/ � ^' L h�
Washing Machine 11.50
City/Stale _�o 'p Zip Phone
1 lkA- 9117c1V', C 1 /,06 Floor Drain/Floor Sink 2" 11.50
Name 3" 11.50
• 4" 11.50
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind ' 11.50 /4
Gas piping requires a separate mechanical permit.
City/State Zip Phone Laundry Room Tray 11.50
Urinal 11.50
Na n • Other Fixtures (Specify) ✓ 15.00 t 6:00
Contractor Mailing Address Suite
11A
075 sw,' 9e 'i/ viTo.J %Y3
Prior to permit City/State Zip Phone / Sewer - 1st 100' 38.00
issuance, a copy , 4 /� ,4- 0/2 9x 7 !� 92 -7,?6 8/ Sewer - each additional 100' 32.00
of all licenses are Oregon Const. C ont. Board Lic.# Exp. Date
required if I Z (5" y 7 Water Service - 1st 100' r• ' 38.00 394c
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 32.00
database Storm & Rain Drain - 1st 100' / , , 38.00 3 $. 0 c
Name Storm & Rain Drain - each additional 100' 32.00
• Architect Mobile Home Space 32.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00
Pollution Device
Engineer City/State Zip Phone Residential Backflow Prevention Device' 19.00
(Irrigation timing devices require a separate
Describe rk to be done: restricted energy permit.)
New Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 11.50
Residential 0 Commercial O Catch Basin 11.50
Additional description of work: Insp. of Existing Plumbing 50.00
per/hr
Are you capping, movin or re lac' any fixtures ?' Specially Requested Inspections 50.00
Y moving p ng Y per/hr
Yes O No O� Rain Drain, single family dwelling 45.00
If yes, see back of form to indicate work performed by Grease Traps 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE .
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL /st .
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 I am the owner or auth • 'zed agent of the owner, and *SUBTOTAL '�11
that • laps su �; . n ,' ..m.11- •. ' ith Oregon State Laws. tRo w
Signa>� j,*f Date 7% SURCHARGE / S •
Con P r spa _Name Phone "'PLAN REVIEW 27% OF SUBTOTAL /
C,- / G / 7 1,� J7 5W , j . � Required only if facture qty. total is > 9 5 4.43
1 BATH HOUSE $178.00 - r TOTAL ��
v�
2 BATH HOUSE $250.00 l
3 BATH HOUSE $285.00 - . *Minimum permit fee is $50 + 7% surcharge, except Residential Backflow
(TM; fee includes all plumbing fixtures In the dwelling and the first' Prevention Device, which is $25 + 7% surcharge
100 feet of sanitary sewer storm sewer and water service) "All New Commercial Buildings require plans with isometric or riser diagram
and plan review
Qom,,,. 1
I;tdststfonnstplumapp.doc 7/8/99 ( F}- . � L A . . , a c g QO r P- O , t
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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:
t: ldstsVormslplumapp.doc 7/8/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
G� q BUP
Date Requested (_2 ( AM PM BLD
Location 1 55°1 ( 1 ' r t}e Suite MEC
Contact Person Ph >`7 I -; D 3/ PLM met '2J 7
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
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PA PART FAIL
LUMB
Post & Beam
Unde Slab
o.• • •
Water Service
Sanitary Sewer
Rain Drains
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 \ \ . Ins Ext
Other
Final
PASS PART 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 3o
q q
BUP
Requested 7 — 1 q L I AM PM BLD
Location 1 25 5 % k 54 Suite q MEC �}
Contact Person (2re - ) Ph g( ! ' M 3 I PLM IC / / - 7o Z/ 7
Contractor J Ph SWR
ptf tC ff 7 Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Claw rawl Drain Inspection Notes: to ld ) '�
SIT
Post & Beam
Ext Sheath /Shear rAl
%?'I S' e T'
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall !'
— 1P 1I N_
Fire Sprinkler -�� Ndr
Fire Alarm i OW�� Susp'd Ceiling /�/
Roof in. � +,
Final
P ART FAIL c - - -_ .
. LUMBI = _
Pos -
• nder Slab
Top • ut
Water Service Ote11(0' cis/ y /ti 5 07367
Sanitary Sewer Q n
Rain Drains ?�- / L(_ % ' Y e /y/9 g
Fin - /
_40 PART FAIL
M - NICAL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date / V Inspector M� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.