Permit CITY OF TIGARD
� i DEVELOPMENT SERVICES PLUMBING PERMIT
'' � .. 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 F'E RM • I T # F'LM98 - 0262
DATE: ISSUED: 08/03/98
$i
PARCEL: 2S 1 1 1 DD— O9c:OO
SITE ADDRESS...: 15915 SW 87TH AVE
SUBDIVISION • CHESSMAN DOWNS �,,ZONING: R -7
BLOCK • LOT •018 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -SF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R3 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 • 1
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Wise ice maker
Owner: FEES
PAT WISE type amount by date recpt
15915 SW 87TH PRMT $ 25.00 JSD 08/03/98 98- 307910
TIGARD OR 97224 SPCT $ 1.25 JSD 08/03/98 98- 307910
Phone #:
Contractor
CHRISTIAN PLUMBING
23172 SW STAFFORD RD.
TUALATIN OR 97062 °-
Phone #: 503 - 638 -8231 $ 26.25 TOTAL
Reg #.. : 00042E
REG.UIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Rough —in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Top—out Insp
approved plans. This pertit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more Final I n s p e c t i o n
•
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 By: �,��� Permittee Signature:"
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
6/16/00 Activities for Case #: PLM98 -00262
1:35:03 PM
Assigned Hold Updated A
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes w
PLMA003 Application received 8/3/98 JSD PASS JSD 8/3/98
PLMA005 Create Permit 8/3/98 JSD PASS JSD 8/3/98
PLMA799 Final Inspection 8/5/98 RB FAIL RB 8/5/98 NO ONE HOME @ 1001 AM
MISSING INSPECTIONS """I'
PLMA720 PLM /Underfloor 8/3/98 JSD 8/3/98
PLMA725 Top -out Insp 8/3/98 JSD 8/3/98
PLMA715 Rough -in Insp 8/3/98 JSD 8/3/98
PLMA740 Misc. Inspection 8/3/98 JSD 8/3/98
PLMA050 (F) Issue permit 8/3/98 JSD PASS JSD 8/3/98
PLMA740 Misc. Inspection 2/15/00 2/15/00 2/15/00 JMT DONE No Hold JMT 2/15/00 research inspection request
PLMA850 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
Page 1 of 1
ITY OF TIGARD Plumbing Application Recd By
3125 SW HALL BLVD. Commercial and Residential Date Recd J
TIGARD, OR 97223 Date to P.E.
Date to 503)`639 -4171 Permit* STS
. 2
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
0 7----C
Name of Development/Project On back indicate Work Performed by fixture.
Job T4 (,L) ■ Sew FIXTURES (Individual) QTY PRICE AMT
Address Street Address Suite Sink 9.00
1 S!) S St) S q 12" Lavatory 9.00
Bldg # City /State Zip Tub or Tub /Shower Comb. 9.00 -
I IC Yd vg 9 1 J
Name _J
Shower Only 9.00
�0. m p Water Closet 9.00
Owner Mailing Address Suite . Dishwasher 9.00
Garbage Disposal 9.00
City/State Zip n �- 7q 5 /
`1 I tO Washin g Machine 9.00
Name C Floor Drain 2" 9.00
J VY. 3" 9.00
Occupant Mailing Address Suite 4" 9.00
Water Heater 0 conversion 0 like kind 9.00
City /State Zip Phone
Laundry Room Tray 9.00
Name Urinal 9.00
,
( h r ; S*,t a, ti,- U o • l i,L Other Fixtures (Specify) �t"c c v ,11 a.y 9.00 G C.X.- Contractor Mailing Address J •
Suite
,231na 5(JV Sf af Y
c,cl 9.00
Prior to permit City /State Zip Phone 9.00
issuance, a copy �ticlkLatl.. . OP 9906`x, '19 1 -94Liq 9.00
of all licenses are Oregon Const. Cont. Board Licit Exp. Date . 9.00
required if i a Lsi it t to -,';0- 00 Sewer - 1st 100" 30.00
expired in COT Plumbing Lic. it Exp. Date
database 3 Li-- 1)0 PS Sewer - each additional 100' 25.00
Name
(� _ 3� - R� Water Service - 1st 100' 30.00
Architect Water Service - each additional 200' 25.00
Or Mailing Address Suite Storm & Rain Drain - 1st 100' 30.00
Storm & Rain Drain - each additional 100' 25.00
Engineer City /State Zip Phone Mobile Home Space 25.00
Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition 0 Alteration 0 Repair 0 Pollution Device
to be done: Residential 0 Non - residential 0 Residential Backflow Prevention Device" 15.00
Additional description of work: Any Trap or Waste Not Connected to a Fixture 9.00
Catch Basin 9.00
Insp. of Existing Plumbing 40.00
per/hr
Existing use of Specially Requested Inspections 40.00
building or property _ per/hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL
I :hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required A Quanity Total is > 9
give:t is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
that ' ..... submitted are in compliance with Oregon State Laws. .6
S . Owner/Agent Date 5% SURCHARGE
o in Name Phone PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. tc:.. s > 9
'74` 7� 77/ - ? _ TOTAL �..S,r
Cr
*Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
- n.doc 97
•
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I:\dstsipimapp.doc 5/97
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 (tiMST /� p6) BUP
4' o62() Date Requested R/ 5' R Q G X PM -BLD
Location /5 915 41dO ?7/1i. Suite MEC
Contact Person Ph PLM
Contractor I A 4 1 , 0 Yk- Ph l 1 1' cf f Lf 1 SWR
BUILDING Tenant/Owner -Walk ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam �, I I/4W
Ext Sheath /Shear , �(i(�C- �'
Int Sheath /Shear _ 1
Framing f ( I no O ` " t
Insulation
Drywall Nailing
Fire wall ` V \A C � � C}--✓`
Fire Sprinkler Fire Alarm �� SAy\i'LiLdx—.Asj
Susp'd Ceiling 3
Roof
Misc: iLtc_.,/ \ j / L, c)
Final
PAS _ PA FAIL
BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rai Drains
final
PASS 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
Approach /Sidewalk
Other Date r Inspector • Ext J 1 I
Final
PASS PART FAIL 0 NOT REMOVE this inspection record from the job site.