The URL can be used to link to this page

Permit CITY OF TIGARD PLUMBING PERMIT � I, DEVELOPMENT SERVICES PERMIT #: PLM2001 00189 '° � ' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/9/01 PARCEL: 2S103AA -01909 SITE ADDRESS: 12385 SW 106TH DR SUBDIVISION: COTTONWOOD PLACE ZONING: R -4.5 BLOCK: LOT: 012 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install back flow preventor FEES Owner: Type By Date Amount Receipt FLATTERS, JAMES G PRMT CTR 5/9/01 $36.25 27200100000 E M 5PCT CTR 5/9/01 $2.90 27200100000 12385 S 12385 SW 106TH AVE TIGARD, OR 97223 Total $39.15 Phone 1: Contractor: STECKLER LANDSCAPING 17000 SW MCCORMICK HILL RD HILLSBORO, OR 97123 REQUIRED INSPECTIONS Phone 1: 503-628-3614 RP /Backflow Preventer Reg #: PLM 6836 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 -198 . Issued By: Permittee Signatu . ��- �—�� Call 503) 639 -4175 by 7:00 P.M. for an inspection need • . he next • •• s s day Plumbing Permit Application Date received: .�/l D /p/ Penni no /3?0? dv / _ D D/gf ,, , City of Tigard Sewer permit no.: Building permit no.: ' Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement Cl Food service ❑ Other: JOB SITE INFORMATION FEE S('IIEDULE (for special information use checklist) Job address: i . ' 1 e i ; / S•k c( le. D Description Qty. Fee (ea.) Total Bldg. no.: I Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: I Block: I Subdivision: SFR (2) bath Project name: - 1, kk, , SFR (3) bath City /county: , svu<4 I ZIP: Each additional bath/kitchen scr1ption and location of work qn premises: • ",4. t e, -Akio u. r!' Site utilities: , j .6 , p. Q4.44..4 (v`,a 1 2-4) i , t (t, 44 sl / t'JQ y Catch basin/area drain Est. date of completion/inspection: / Drywells/leach line /trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: _' -1“.1i. I e... (�,, ,s4e / �j::.c'+FN .cam� ff i n F • Jc' �U.� c- Manholes Address: ice: 54-) lU ciet :ca it; irT61 Rain drain connector City: 1..(,; If 1694c. I State: t1►; I ZIP: d •3 i Z 3 Sanitary sewer (no. lin. ft.) Phone: I Fax: I E -mail: Storm sewer (no. lin. ft.) CCB no.: ( I T pC 5 I Plumb. bus. reg. no:& % 6i..54 Water service (no. lin. ft.) City/metro lic. no.: 7 Fixture or item: Absorption valve Contractor's representative si a re:. � ` � —�' _Back flow preventer Print name: l,'Ta,re,�•u; / late: 5 G' Backwater valve Basins/lavatory Name: Clothes washer Dishwasher Address: Drinking fountain(s) City: I_ State: I ZIP: Ejectors/sump Phone: Fax: E - mail: Expansion tank O11NER Fixture/sewer cap Name (print): 31 vii r 1 ci f Floor drains/floor sinks/hub Garbage disposal Mailing address: j Z 3UT 5s4; i v f{i Or Hose bibb City: I `ciCx -rd I State: 04Z I ZIP: Ice maker Phone: , 5c/ 1 5S" I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump ENGINEER Tubs/shower /shower pan Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other: Phone: I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information Minimum fee $ Notice: This permit application ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $ Credit card number: / / State surcharge (8%) .... $ Expires within 180 days after it has been TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440-4616 (6i50/COM) • PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2- family dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT 16.60 for each utility connection) Lavatory One (1) bath $249.20 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain /Floor Sink 2" 16.60 PLEASE COMPLETE: 3" 16.60 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Home New San /Storm Sewer 46.40 Lavatory • Tub or Tub /Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fixtures (Specify) 16.60 Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Sink: 2" Sewer - 1st 100' 55.00 3" Sewer - each additional 100' 46.40 4" Water Service - 1 st 100' 55.00 Water Heater Other Fixtures Water Service - each additional 200' 46.40 (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device* 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram is required if Quantity Total is > 9 *SUBTOTAL 2 8% STATE SURCHARGE ✓tr * *PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total is > 9 TOTAL $ * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge. ** All New Commercial Buildings require plans with isometric or riser diagram and plan review. i:\dsts \forms\plm- fees.doc 10/10/00 �� 70 CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 a� f J f - - -^ - • --�-- ==�� BUP - Date Requested Ste/ 2 AM PM BLD Location / 2-3 /. 5 / L Gz Pv Suite MEC Contact Person Ph //7 Z 8Z3 3 argi 266/ -6 C.) /51 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 r Misc: (y Final PASS PART FAIL k/ Po ti Bea V Under Sla 6,6a a Top Out Water Service Sanitary Sewer SS 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 (5 Approach /Sidewalk Date ' 7 </ V t Inspector \ Ext l Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. Sy,r- CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24,-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 5 —/- AM PM BLD Location /L3 2-.5 GJ /6 G` Suite MEC Contact Person Ph 4 2 - PLM ,20O / 6 Contractor Ph SWR BUILDING Tenant/Owner 0,4 Ze C ELC Retaining Wall ELR Footing Access: 'W a., N, Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes /� Slab � ianiee 4L se 4 % 3 7 l 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 MB1113} Post & Beam Under Slab Top Out SP•-/nk.u. Water Service ',pi-- Sanitary Sewer Rain Drains Final PASS PART FAIL ( , MECHANICAL Post & Beam Rough In v Gas Line V Smoke Dampers Final PASS PART FAIL ELECTRICAL k Service Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ requ red 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 P Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. i -3111' r- a " Cfl Y OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour In3pection Line: 639 -4175 Business Line: 639 -4171 M --y i_____. BUP Date Requested s — / U AM ( i OPM BLD Location X 23 irS 5 w /QL d r 4 Suite MEC Contact Person Ph C/Z 1 --- $ Z 33 421 2d)/ -O v / 9f 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 Ina mingth /Shear 1 d] I ,/_ ( j Fra _ -(1 C c f .—v--- Q ming � (�(.(/V! -1r1 �� !/1. � � Insulation Drywall Nailing 4 ///e/ � 6, Tip. ( , r T 8 L-✓` cS Firewall ( 1 ,' ^ �� 1 A 1 & S � , / Fire Sprinkler \ �V�J `� Vv Fire Alarm (� ( _ AA---- % l / Susp'd Ceiling '� _ S ]� `, ,, S Roof O0 - 'r•1� ∎ S \ Z ,--,./1 C - l_X Misc: Final - PASS PART FAIL 11 - ` - - - (: - ' 4 .- 4--- -w,c_A—e c \/.2„6 g • . Post & Beam Under Sla Top Out �l Q Q G!C 4,,, v � -tt.7' C- < S S ^-(5 -(5 t Water Sery Sanitary Sewer Rain Drains VIAP C-r O Final ` n — ` . PASS PART FAIL P `� i - 1� ‘ A , n _ ■ , � ,_ MECHANICAL 0 6 r de et_- -1, '-e_ LOCA 1 Cam' Post & Beam Rough In Gas Line � \ (� ( _ Smoke Dampers ) 0 l ri' l� ' --r v 0 ^� — O t ' - e C 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 //`` ate I V l Inspector r ff Other v �' Ext 5 l Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • BUP - Building Permit ELC - Electrical Permit Inspection Description Date Passed By 4 Inspection Description Date Passed By — Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing J Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation 4 Inspection Description Date Passed By Drywall nailing Post/beam mechanical Suspended ceiling Gas line Engineered soils • Mechanical rough -in Welding Lab Final Concrete Lab Final Fire damper Bolting Lab Final Duct work Structural observation Smoke detector Mechanical final Fireproofing Lab Final — Final inspection PLM - Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer S// 7/0 / Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final , // 7/ / ea, Sprinkler supply lines Pt s -� Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04 /17/01 CI TY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM2001 - 00189 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/9/01 PARCEL: 2S 103AA -01909 SITE ADDRESS: 12385 SW 106TH DR SUBDIVISION: COTTONWOOD PLACE ZONING: R -4.5 BLOCK: LOT: 012 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install back flow preventor FEES Owner: Type By Date Amount Receipt FLATTERS, JAMES G PRMT CTR 5/9/01 $36.25 27200100000 LORAINE M 5PCT CTR 5/9/01 $2.90 27200100000 12385 SW 106TH AVE TIGARD, OR 97223 Total $39.15 Phone 1: Contractor: STECKLER LANDSCAPING 17000 SW MCCORMICK HILL RD HILLSBORO, OR 97123 REQUIRED INSPECTIONS RP /Backflow Preventer Phone 1: 503 - 628 -3614 Reg #: PLM 6836 t ■ 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 mor 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 -198 Issued By:- Permittee Signatu . Call 503) 639 -4175 by 7:00 P.M. for an inspection need- • e next • ss day