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Permit CITY OF TIGARD , ,,.� DEVELOPMENT SERVICES PLUMPING PERMIT pw PERMIT # PLM98 -0420 ,� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1 1 / 12 /9 8 PARCEL: 2S102CC -02500 SITE ADDRESS...: 13900 SW 102ND AVE SUBDIVISION • FRELEON HEIGHTS NO.2 ZONING: R -3.5 BLOCK • LOT :010 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 • 0 TUB /SHOWERS...: 0 SEWER LINE (ft)...: 100 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Nelson — Must pump, fill, and cap septic system. Owner: FEES WILLARD E NELSON type amount by date recpt 13900 SW 102ND PRMT $ 30.00 JSD 11/12/98 98- 310761 TIGARD OR 97223 5PCT $ 1.50 JSD 11/12/98 98- 310761 Phone #: 639 -3502 Contractor MILLER & SONS CONTRACTORS INC 23880 SW MIDDLETON RD SHERWOOD OR 97140 Phone #: $ 31.50 TOTAL Reg #..: 000036 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Sewer Inspection 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 188 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-N10 through OAR 952 -8001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. G-74L7:12) 1 / Issued B Permittee Signature„ , ,.la.0 ./ !A A, + + + + + + + + + + + + + ++ ++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF- TIGARD Plumbing Permit Application Plan Check# _, 13125 SW HALL BLVD. Commercial and Residential Recd 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 Related SWR # 9 - c i t' Called e Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job Sink 9.00 Address street Address I Suite Lavatory 9.00 / Z 3 oo 6,N, , / C,2 +1 c ) Tub or Tub /Shower Comb. 9.00 Bldg # Ci /State Zip Shower Only 9.00 I \ lr d I OP 9 9a Water Closet 9.00 Name _ _ W I I I? r a / ! T e /Jr" O n Dishwasher 9.00 Owner Mailing Address r ' d Suite Garbage Disposal I 9.00 / 3900 5,40, /D,2 Washino Machine 0 on Ci tate Zip Phone V 7 / , /9-r / �p 9 o ,gg_3 O d ) � x�� Floor Drain /Floor Sink 2" 9.00 N ' pp�� arbe C� F- 3" 9.00 W1 1:, fce15er? 4" 9.00 Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 9.00 /3 S W, 1061 gl Gas piping requires a separate mechanical permit. City/State , Phone Laundry Room Tray 9.00 t_�q 4 rod I OR 97ac 6 3 9-3302 Urinal 9.00 Nr,ip �) ( I�1' d ,.")t, hl I CC it 4- rPc t . f� , ..Z pie-- _ Fixtures (Specify) 9.00 Contractor Mailing Address Suite 9.00 .,38F'Gsu%, 1%1J letoi e / 9.00 Prior to permit City /State Zip Phone l Sewer - 1st 100' I �` 30.00 - Ir. issuance, a copy 6 fi E' , tc)Poci ,(,'t/ 9 7 I e'/ D � �S - F7.J 42. J/"� Sewer - each additional 100' 25.00 of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date required if O o 3 64/y 1 Water Service - 1st 100' 30.00 expired in COT Plumbing Lic. # Exp. Date Water Service - each additional 200' 25.00 database 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 32" Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00 Residential 0 Commercial 0 Catch Basin 9.00 Additional description of work: Insp. of Existing Plumbing 40.00 /,loo tcla 4 0 0_, e 7o 6 w e r per /hr Specially Requested Inspections 40.00 per/hr Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00 Yes O No O Grease Traps 9.00 If yes, see back of form to indicate work performed by fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL Isometric or riser di agram is required if Quantity Total is > 9 WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL � 5/) 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 / 571 that plans submitted are in compliance with Oregon State Laws. Signature of Owner /Agent Date * *PLAN REVIEW 25% OF SUBTOTAL n ‹ . 2/ i 9- y1 n e, 1 / � /ge Required only d fixture qty. total is > 9 TOTAL 4a1 Co ntacttPerson �f Phone - j/S -- �� V7 *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow CJ pC/1 'LQ/ (p, f; J Q �Q r( �� --,5502_ *Minimum Device, which is $15 + 5% surcharge p * *All New Commercial Buildings require plans with isometric or riser diagram ] � -1„,,-).A..5 and plan review I: \dstsWlumapp.doc 7/2/98 + � !/ � G 3�z-i & CP ) e"„ � 1,�, r - 35 ( D) I 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 /Floor Sink 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I_ \dstslplumapp.doc 7/7/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ��[[� BUP Date Requested `T -c- 6 0 AM PM BLD Location l qa) / 0; n Ave Suite MEC Contact Person Ph PLI1g 00 Li Contractor Ph SWR) - °0 3/ BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Foundation A NOT REQUESTED FPS Ftg Drain FOUND DURING RESEARCH SGN Crawl Drain Slab Ir NO INSPECTION(S) FOUND IN FILE SIT Post & Beam ul ! T' 9 „ ,/ 6' 1 I Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm P/5 y 6 / / . _ 7y - Susp'd Ceiling / Roof Misc: Final PASS PART FAIL 'rims Cc S 6- M4 Post & Beam Under Slab Top Out Water Service SEjtary Se Rain Drains r.� f 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date C / / // Inspector 7-6." 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 Z1 AM PM BLD Location Suite MEC Contact Person �, Ph C 45g PLM Contractor Ph SWR 3/ 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 PLUMBING Post & Beam Under Slab Top Out Water Service ' - Zi ary Sewer Rain Drains .PA ) PART 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk , other Date " 2-'4,' / Inspector Ext �� Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. f 1