Permit CITY OF TIGARD
k �� n �,��i�;i DEVEH OPIVIENo SER 6CES PERMIT #.. T= � -0275
DATE ISSUED: 09/25/98
PARCEL: 2S112DC -01400
SITE ADDRESS...: 15875 SW 74TH AVE #A * **
SUBDIVISION : CREEKCIDC PARK ZONING: I —P
BLOCK U/ LOT °004 JURISDICTION: TIG
CLASS OF WORT'.° ° :NEW GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE °COM WASHING MACH ° 0 BACKFLOW PREVNTRS ° °: 2
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 2
TUB/SHOWERS...: 0 SEWER LINE (ft)...: 300
WATER CLOSETS.: 0 WATER LINE (ft)...: 500
DISHWASHERS 0 RAIN DRAIN (ft)...: 100
Remarks: Plumbing rough —in, Bldg. A shell
Owner: FEES
PACIFIC REALTY VENTURES INC type amount by date recpt
17700 SW UPPER BOONES FERRY RD PRMT $ 258.00 GEO 09/11/98 98- 309072
PORTLAND OR 97224 PLCK $ 64.50 GEO 09/11/98 98- 309072
SPCT $ 12.90 GEO 09/11/98 98- 309072
Phone #:
Contractor
C EAGLE PLUMBING ENTERPRISES INC
13801 S FORSYTHE RD
OREGON CITY OR 97045 -1219
Phone #: 760 -5565 $ 335.40 TOTAL
Reg #° .: 000479
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Code, State of Ore. 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 952-0w You Nay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By: KAA NW/ 1 "' J Permittee Signatur e la\ 6,00
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + ++ + + + ++ + ++ + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + ++ + + + + ++ + + + + ++ + + + + + +++ + + ++ + + ++
CITY OF TIGARD Plumbing Permit Application Plan Chec 4 - (�C-
13125 SW HALL BLVD. Commercial and Residential Rec'd By ia7/J
TIGARD, OR 97223 Date Recd S=. -6 -6 1111 yt � .
(503) 639 -4171 Date to P.E. ` D / \
Print or Type Date to,DST # �3/ A )
Permit # ft- - -� - ,, 1 ►11= Q1 1
Incomplete or illegible applications will not be accepted Related SWR #.w - oZOi
Called _a \ .• . ' 0 /
w( q-1 1
Name of Development/Project FIXTURES` (r;ndtvtdual) i D i li , '` , NM Pi210E� AMT
Job C.2eakv 1 8vs tN� (MLIs Sink „. , 9.00
Address I s dress /5 '7� S4 Lavatory 9.00
1 ri Tub or Tub /Shower Comb. 9.00
Bldg # City /State Zip o
Ttg 0 ( , 2 Shower Only 9.00
Name i _Water Closet 9.00
- /17G //4Z:71( U / - Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00 .
/7 *700 010. &NLs Lizo A / 6'0 Wash Machine 9.00
City/State Zip Phone Floor Drain /Floor Sink 2" 9.00
% 'a l'2 77 7,2q- 670 'ti
Name 3" 7 t 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
Name
Other Fixtures (Specify) 9.00
Cr Pt(:, L.C. Q LV V 70.3 @ �` /
Contractor Mailing Address Suite 72'644.- /25 2 !
9.00 I[�
13801. 13801. S t=oils ,eT4c - _ 9.00 J
Prior to perrnit City /State Zip Phone Sewer - 1st 100' /` 4 30.00 - ta�
issuance, a copy O Cti ( 04_ 'I 70 `fY fe,1" ' Zm3 i
Sewer - each additional 100' .sit 25.00 �=6
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if e1 7 9 ct -418 Water Service - 1st 100'r 30.00
expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 7•' 25.00
/2L- database
3-159 toe, &4 --19 S torm & Rain Drain - 1st 100' 411/5 -7 30.00
Name Storm & Rain Drain - each additional 100' t, 25.00
Architect • V L �� -a16- r/ti. Z_/L 5 Mobile Home Space 25.00
or Mailing Address ' Suite Commercial Back Flow Prevention Devices or Anti - y' 25.00
333 - S Mi.-MLL.y /4 Pollution Device 4-0 F /St `T - j J�„
-
Engineer City /State Zip Phone Residential Backflow Prevention Device* 15.00
! / L y 4 • L r f Q / L c 7 2 - a / 2 - 4 - 45 3 (Irrigation timing devices require a separate
Describe work to'be done: restricted energy permit.)
New 0 Repair 0 Replace with like kind: Yes 0 No O Any Trap or Waste Not Connected to a Fixture 9.00
Residential 0 Commercial 1.+l Catch Basin e -GI /S7 p.. 9.00
Additional description of work: Insp. of Existing Plumbing /� 40.00
U ri 0 ` - '1." C. j U.1 'D S ^.'YL per /hr
OJT L I4t aiD U1.4II::$4._ Specially Requested Inspections 40.00
30
4O r ><Tv b 00
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30..00
Yes 0 No Grease Traps 9.00
If yes, see back of form to indicate work perform_d by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE ��� " `�
I some t r i c or r d i agram is required A Quantity Total is > 9 � ,
WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL I 0 -
I 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 WAIT
that plans submitted are in compliance with Oregon State Laws. t7,4
Signature of Owner /Agent Date * *PLAN REVIEW 25% OF SUBTOTAL r'r�V
Required only if fixture qty. total is > 9 k } 1 tt��
is -y `I8 TOTAL ; ' /_q / 4tl
Contact Person Name Phone r / E 4 SZIA7 r 'AJ '
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
C 8 % q L C42do5 (4J"0 - $7 Prevention Device, which is $15 + 5% surcharge
* *AII New Commercial Buildings require plans with isometric or riser diagram
and plan review
I: \dsts\plumapp.doc 7/2/98
.
PLEASE COMPLETE:
F'xture T ype Quantity by Work Performed
'`p /r, ro Ne Moved Replaced Remo /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: •
•
I'ldstslplumapp . doc 7/7/98
I
/� I,, ccum Iative Sewer Tally
Tenant Name: a ne_ ,I4J,t°,0 & 5 (i/�QSS r oar o d • 4 _ This SWR# 9' - Ow
Address:) "CIS SW 1 `t' This This PLM#: e A - bz 7
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub/Shower 4
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4
- 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 , \43, ''
Ice Machine/Refrigerator Drains 1
Oil Sep (Gas Station) 6 l ` ^ Ii. Vehicle Dump Station 16J` \
Shower - Gang (Per Head) 1 V`I
ri
•
-Stall 2 -
Sink - Bar/Lavatory 2 t V A S'
- Bradley 5 f" 4
- Commercial 3 \ , \ f
- Service 3 \ �r `�� ^
Swimming Pool Filter 1 ‘
Washer - Clothes _ 6
Water Extractor 6
Water Closet - Toilet 6
Urinal 6
TOTALS
Total fixture values: divided by 16 = EDU � �� °`
HISTORY i => ;t,�4� -10( ad AsC. f' ( :_v0. t t
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
i :\dstslswrtaly.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
/6,2 :2/ Date Requested /6 /Z' AM ;PM BLD
Location 7CJ' 7S 574) 7V Suite 64(j- # MEC
Contact Person N/ Ph PLM i(f 7�
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: if � � W .J 77 SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation -
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
P z FAIL
-. -.
Under Slab
Top Out
ter Se }'
Sanitary Sewer
Rain Drains
RT FAIL •
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 Inspector Ext
Other -
Fi .
PART FAIL DO NOT REMOVE this inspection record from the job site.