Permit :_ CITY OF TIGARD
, : DEVELOPMENT SERVICES PLUMBING PERMIT
'� !+L " I (� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # • PLM99 - 0089
DATE ISSUED: 03/29/99
PARCEL: 2S113AD -01900
SITE ADDRESS...: 16600 SW 72ND AVE #B -10
SUBDIVISION • ROSEWOOD ACRE TRACTS ZONING: I —L
BLOCK • LOT •009 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •COM WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:B FLOOR DRAINS • 0 TRAPS • 0
STORIES • 0 WATER HEATERS • 0 CATCH BASINS • 0
FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0
SINKS • 0 URINALS 0 GREASE TRAPS • 0
LAVATORIES • 0 OTHER FIXTURES • 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 300
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Replace existing water service.
Owner: FEES
PAC —TRUST type amount by date recpt
16600 SW 72ND PRMT $ 55.00 GEO 03/29/99 99- 314022
TIGARD OR 97223 5PCT $ 2.75 GEO 03/29/99 99- 314022
Phone #:
Contractor
POWER PLUMBING CO
P 0 BOX 23144 .
TIGARD OR 97281
Phone #: 244 -1900 $ 57.75 TOTAL
Reg #..: 000523
REQUIRED INSPECTIONS
This pernit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 1: 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 say
obtain copies of these rules or direct questions to OIJNC by calling
(503)246 -1987. •
Issued By: i
, i / _/ / Perm ittee Signature �m OSO � 7
-' ► '�
+ + + + +++ + + + + + +++ + + + ++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + ++ -,'-'+++ ++ + ++ + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection nee.ed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
8Ir O I-� TIGARD Plumbing Permit Application Plan Check#
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
(503) 639 -4171 Date to P.E.
Print or Type Date to DS
Incomplete or illegible applications will not be accepted Permit #Ldti! � Z
Related SWR #
Called
Job � of Development/Project 6)AR_e-- FIXTURES'.(Itidivldual) - ' -, ;' . ' ' "QTY`; -PRICE .AMT,
( nf1tJ S Sink 9.00 .
Address Stet Address % Suite Lavatory 9.00
l 0 D S W 1 . Tub or Tub /Shower Comb. 9.00
Bldg # / 0 City /State Zip Shower Only 9.00
_ 776 t■
NaTei Water Closet 9.00
st•R.-- `C w5, Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
Washing Machine 9.00
City /State Zip Phone Floor Drain/Floor Sink 2" 9.00
Name 3 9.00
4" 9.00
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00
Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
' dt Other Fixtures (Specify) 9.00
Contractor _Wailing Address Y Suite y 9.00
t -)0 - - I (4y 9.00
Prior to permit / ate Zip Phone Sewer - 1st 100' 30.00
issuance, a copy ' v1 1'14 pc/i{ -(y 00
Sewer - each additional 100' 25.00
• of all licenses are Oregon �C � Cpnt. Board Lic.# Exp. Date
required if Water Service --1st 100' 1 30.00 30. o_
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' ! 25.00 !=.
database 39-150 P S Storm & Rain Drain - 1st 100' 30.00 _
Name . Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00
or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollution Device
Engineer City /State Zip Phone Residential Backflow Prevention Device' 15.00
(Irrigation timing devices require a separate
_ Describe work to be done: restricted energy permit.)
New 0 Repair X Repla with like kind: Yes,' No O Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial Catch Basin 9.00
Additional description of work: ,( Insp. of Existing Plumbing 40.00
e� la- i- eire /wy LIAdfa C- 6-gJ2 -u c.�A- per/hr
Specially Requested Inspections 40.00
per/hr ,
Rain Drain, single family dwelling 30.00
Are you capping,- moving or re lacing any fixtures?
Yes 0 NO Grease Traps 9.00
If yes, see back of form to indica a work performed by QUANTITY TOTAL p o
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required if Quantity Total is > 9
WORK COULD RESULT IN INCREASED SEWER FEES. `SUBTOTAL - 00
1 hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE ; -
t . • . ubmitted are in compliance with Oregon State Laws. °
Signature 4 caner /Ag Date *'PLAN REVIEW 25% OF SUBTOTAL
,3 Required only if fixture qty. total is > 9
TOTAL 7 Ca
0 C
C • P @rson Narr Phone \ p'� V1. Y/ ,,244( _�D *Mini permit fee is $25 + 5% surcharge, except Residential B ckflow
�� Prevention Device, which is $15 + 5% surcharge
All New Commercial Buildings require plans with isometric or riser diagram
and plan review
I: dststplumapp.doc 7/2/98
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 (S S
COMMENTS REGARDING ABOVE:
I: dstslplumapp.doc 7/7198
CITY OF TIGARD BUILDING INSPECTION DIVISION �("sT
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/ Date Requested ?3,00 AM PM BLD
Location 16 6-C1) ' 7�. Suite g — /� CZ- A
Contact Person Ph 99'c �9
Contractor Ph SWR
BUILDING t/Owner / ELC
Retaining Wall ELR
Footing Access: i 1 i
Foundation ' FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear � 7
Framing
Insulation GG A // , nnnn ,, , ,,
Drywall Nailing 104n q � 0� 0 / - reptAge ��� _I / L eAti ( C SQL
Firewall L
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ---■"--- •
Roof
Misc:
Final
ES ti S i.se PART FAIL 11))
MBINC)
Under Slab
Top Out
Water Service
Sanitary Sewer
R� *rains
air/ 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 / 745 Inspector 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
BUP
Date Requested AM PM
BLD
Location / 4 ‘ 7 7/ Suite '✓ - l0 MEC
Contact Person Ph L r9- /?" PLM —
Contractor (/ Ph SWR
BUILDING Tenant/Owner O.Ge1 ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam •
at Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
e
Sarn ewer
Rain Drains
F'
PASS ART FAIL
ME 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
BackfilllGrading
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 3 Inspector /e.(1 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
BUP
Date Requested AM PM BLD
Location !p ( --7 4 d *Jo S it�t a EC b G
— 6oz 76
Contact Person Ph PL 9 ? E 7
Contractor Ph SWR
BUILDING Tenant/Owner v r� CiOlsi , �5 (2/?W_A LC
Retaining Wall . ELR
Footing .�___ _ __—
Foundation NOT REQUESTED FPS
Ftg Drain FOUND DURING RESEARCH
Crawl Drain I — SGN
Slab NO INSPECTION(s) IN FILE
- SIT
Post & Beam -
Ext Sheath /Shear
Ina mingth /Shear - �� / \ _ W _ (� '
Framing furig9 b 0 0 ` l,G� C2 �x�ST a./.61 aL� J [
Drywall on j _ 9 .5-1
Drywall Nailing (�/ t '�P / -2-
Firewall `/� /� — 7
Fire Sprinkler �' V t v • U 2 , / T / b&
Fire Alarm
��j � 1 - Z� / C) 5
Susp'd Ceiling -C�tJ�
Roof
Misc:
Final
1:S.g P,4kT FAIL
LUMBIN ; /1�, / /e/
Post &Beam ' ' / i
Under Slab
Top Out
Water Service / /
Sanitary Sewer / `/
Rai Drains �, i ` , . `.- -
- • RT FAIL
CHANIC
Post & Beam �—
Rough In
Gas Line y q �/
ll
S ke Dampers C
Sin l
"PASS PART FAIL / - 7
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 � �
Other
Date L Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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