Permit CITY T I A ® PLUMBING PERMIT
'I DEVELOPMENT SERVICES PERMIT #: PLM2000 -00070
yc 11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/23/2000
SITE ADDRESS: 15865 SW 74TH AVE 100 PARCEL: 2S112DC 01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 1 URINALS: GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 3 WATER LINE: ft
DISHWASHERS: 1 RAIN DRAIN: ft
Remarks: Plumbing TI
FEES
Owner:
Type By Date Amount Receipt
CREEKVIEW BUSINESS PARK LAND PRMT BON 03/23/200C $103.50 0000890
JDS, LLC & PACIFIC SANTA FE PLCK BON 03/23/200C $25.88 0000890
17700 SW UPPER BOONES FRY 100 5PCT BON 03/23/200C $8.28 0000890
PORTLAND, OR 97224
Phone 1: 503 -670 -9300 Total $137.66
Contractor:
EAGLE PLUMBING
13801 S FORSYTHE RD
OREGON CITY, OR 97008 REQUIRED INSPECTIONS
Phone 1: 503 - 650 -8703 Underfloor /Underslab
#: L IC 47914 Top -out Insp
Reg Final Inspection
PLM 3 -154PB
ORIGINAL
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 1 i v✓ Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
I` •
Accumulative Sewer Tally
Tenant Name: 6j'1��U11 1 .-.(-{/t.�, This SWR# 7 rtZ - 0°0
Address: I Co � W 7 This PLM#: 7-1X' - e90070
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added # added #s total
Count off count value values
Baptistry/Font 4 ,
Bath - Tub/Shower 4
- JacuaiMlhiripool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4 41-
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain/sink - 2 inch 2
- 3 inch 5
- 4 inch 6
- Car Wash Dm 6
Garbage Disposal 16
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) 48
Ice Machine/Refrigerator Drains 1
Oil Sep (Gas Station). 6
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
Stall 2
Sink - Bar/Lavatory 2 '; 6
- Bradley 5
- Commercial 3 i 3
• - Service 3
Swimming Pooi Filter a 1
Washer - Clothes _ 6
Water Extractor 6 •
Water Closet - Toilet 6 . /'F/
Urinal 6
TOTALS P /.7 3/ /
Total fixture values: / 1 divided by 16 = , C / EDU 1...._________.-
HISTORY 1 Ev c�` �q--
PLM# .,, ? 6, EDU# / SWR #1' -- co02 PLM# . EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR# _
PLM# EDU# SWR# PLM# EDU# SWR#
ildstslswrtaly.doc
•
C r \ .
ITY OF TIGARD Plumbing Permit Application Plan Check # 3 - / C
13125 SW HALL BLVD. Commercial and Residential Rec'd By k
TIGARD, OR 97223 • Date Rec'd 3 - 3 - 00
(503) 639 -4171 Date to P.E. -
Print or Type Date to DST �•J
Incomplete or illegible applications will not be accepted Permit #�NI - ott
R elated SWR # - C Y �
Called J-,70-00
t , rr 1atG5S,- r /d,>rfr'
Name of Development/Project FIXTURES, (Individual) i ., Q PRIC + AMA;
Job cite'EKV Ian 8 uric. i3 Sink - if 11.50
Address Street Address ;y„ Suite Lavatory - 11.50
6 Set (aS .3 7 AY 1 OO Tub or Tub /Shower Comb. 11.50
Bldg # City /State Zip Shower Only 11.50
Name CgZ, -urn) ltSVi iP l �. Water Closet/{ el (Specify) 3 11.50
3 S L Le * Pact~tiL Sire Dishwasher 1 11.50 •
Owner Mailing Address Suite Urinal 11.50
17700 Sul' ()IP -6F lCP 100 Garbage Disposal 11.50
City /State Zip Phone Laundry Tray 11.50
A - 0 7 7 2 , . ` 1 6 . 7 0 S 300
Name Washing Machine /Laundry Tray (Specify) 11.50
C 4.tn Lr - V IN C Floor Drain /Floor Sink . 2" 11.50
Occupant Mailing Address Suite 3" 11.50
AZO Ve 4" 11.50
City /State Zip Phone
Water Heater 0 conversion 0 like kind 1 11.50
•
N Name Gas piping requires a separate mechanical permit.
MFG Horne New Water Service 32.00
Fletta t C p tr.3v4.6Ie,c)
Contractor Mailing Address Suite MFG Home New San /Storm Sewer 32.00
133 5 FoLsitve Hose Bibs 11.50
Prior to permit City /State Zip Phone Roof Drains 11.50
issuance, a copy 11»ia Cs pL glair 650-1S7
Drinking Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if 4i79 I .( g -2.3-01
Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date
database 2 - 1 5t e6 _ y-30 -0A
Name / -
Architect ft�I L_ D.24 .4 1 G,,,t C,t2Cc,, Sewer -1st 100' 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
11 V30 1639-,12 32.5- Water Service - 1st 100' 38.00
Engineer City/State Zip Phone
c ad' 9( 9 7 2214 -055 -L Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New OD Repair 0 Replace with like kind: Yes 0 No O Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial ID 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 0 No ® Inspections s 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 hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total is > 9 t
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL w �/
that plans submitted are in compliance with Oregon State. Laws. rc3Y
Signature of Owner /Agent Date
C A_ c___-____ 3' z- 00. 8% SURCHARGE i0 gyp(
Contact Person Name Phone - /
C ` C_rto CAS V703 * *PLAN REVIEW 25% OF SUBTOTAL '" 7 °° "a - 1 •
Required only if fixture qty. total is > 9 , n
1 BATH HOUSE $178 00 , O TOTAL
2rBATH HOUSE 50 1 :rte : , 4 7.66
3tBATH HOU*$285 00 s
(This fee includ aII pi nt g in the an the first *Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention
� 100 Sanitary! sewe r Stor sel & r and water Service) F * y Device, which is $25 + 8% surcharge
..,,.
• **All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
Iidststformslplumapp.doc 10/8/99 - ---
PLEASE COMPLETE:
Fi Typed Quantity °byWorkP�erforrried
M ed p
�s ; Repla Removed /Ca ecl
a INew o�
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher C
Urinal
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
• 3"
4"
Water Heater
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:ldsts\forms\plumapp.doc 10/8/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Sf 1 Iq /a) AM PM BLD
Location 1 ) cftt / 40-€• S uite (,(:��� MEC
Contact Person ffiu5 UL Ph ("SO -g PLM ZO - 00o7D
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
-
PASS PART FAIL
ILUMBIIR J
Post & Beam
Under Slab •
Top Out
Water Service
Sanitary Sewer
Rai Drains
ina
405 PART FAIL
i�'�IF' HANICAL
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
Other Date /�'l (9 t. Inspector e97 '� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
I` .
r .
_. , Eagle Plumbing Enterprises, Inc.
13801 S. Forsythe Rd. • Oregon City, Oregon 97045 • Phone (503) 650 -8703 • Fax (503) 650 -8720 • CCB #47914
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