Permit 4" CITY �
DEVELOPMENT PLUMBING PERMIT
�°�~��~°~��" "�"�~o~» SERVICES PERMIT # • PLM97-0164
13125 SW Hall Blvd., Tigard, ~��` ' E ISSUED: 05/07/97
~ RCEL: 1S134BC-90012
SITE ADDRESS...: 10907 SW 121ST AVE 446
SUBDIVISION....: WOODSPRING CONDOS • • ZONING: R-7'
BLOCK. . . . . ..... : LOT. . .. ......... :12 JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF`USE.�.:SFA• WASHING MACH...—: 0 BACKFLOW PREVNTRS..0
OCCUPANCY GRP..:R3 FLOOR DRAINS......: 0 TRAPS : 0
STORIES..�... .. : 0 WATER HEATERS ^ • 1 CATCH BASINS. ...... : 0'
FIXTURES LAUNDRY TRAYS.....: 0 SF RAIN DRAINS - 69
SINKS......... : 0 URINALS ^ 0 GREASE TRAPS.......: 0
LAVATORIES ^ 0 OTHER FIXTURES....: 0
TUB/SHOWERS:..: 0 SEWER LINE' (ft).—: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS ^ 0 • RAIN DRAIN (ft)...: 0
Remarks: Electric to electric water heater replacement
Owner: — FEES
MILDRED QUEEN type amount by date recpt
10907 SW 121ST PRMT $ 25.00 JSD 05/07/97 97-294271
TIGARD OR . 97223 5PCT $ 1.25 JSD 05/07/97 97-294271
Phone #: 590-2567
Contractor
GEORGE MORLAN PLUMBING '
5529 SE FOSTER RD
PORTLAND OR 97206
Phone #: 771-1145 $ 26.25 TOTAL
Reg #..: 000027
REQUIRED INSPECTIONS -------
This permit is issued subject the regulations , contained in the Misc. 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 180 days uf'issuancei or if work is-suspended for more
than 180 days. ' .
•
Permittee Signature:
=�—~��r ---' -----'
Issued By: .
�~
all for inspection — 639-4175
•
CITY OF TIPARD Plumbing Application Redd By
13129-SW HALL BLVD. Commercial and Residential Date Reed ric
TIGARD, OR 97223 Date to P.E.
(.503) 639 -4171 10 S 1 - I Date to DST /�
Permit f Pc,,t 9 "t516n(/
Print or Type Related SWR S
Incomplete or illegible applications will not be accepted called
Name of Development/Proiect FIX aM E8 44 1 .0Mdual) t .taleik.` P EiI
Job Sink t , _.. i
9.00
Address Street Address Suite Lavatory 9.00
1 0907 Sw 12 \ Tub or Tub/Shower Comb. 9.00
Bldg S City /State ZI Shower Only - 9.00
_ TI QYd 91' 3 Water Closet
Name 9.00
I� � I e I
l f Q c. U Q2 �Y� Dishwash 9.00 •
Owner Mailing Address Suite Garbage Disposal
p `' 9.00
l 6. 7 01 1 1 k Washing Machine 9.00
Zip Phone - Floor Drain 2' 9.00
Clear( 9 390
Name - 3 ' 9.00
4 ' 9.00
Occupant Mailing Address Suite Water Heater - 9.00
Laundry Room Tray - - 9.00
City/State Zip Phone Urinal
9.00
-
Other Fodures (Specify) 9.00
` j / `I\nY 9.00
Mail ( �ff 9.00
Contractor Ma1 #15 Rj,C c nil. Suit • � - 9.00 .
(Prior to issuance to Zip Phone -
applicant must I GUY a -711 04-1371 7 9.00
provide all Oregononst Con Board Lice Exp. Date - 9.00
�C
contractors 0 27 34 . ( ; - / 7 - - - -_
license Lt.* Exp. Date Sewer - 1st 100- 30.00
30.00
information (1 660 P Q 6 70 - `1 7 . Sewer - each additional 100' 25.00
for COT COT Business Tax or Metro S Exp. Date
database). Water Service -1st 100' - ' 30.00
Name Water Service - each additional 200' 25.00
Architect Storm & Rain Drag, - 1st 100' • 30.00
Or Maifing Address - Suite Storm a Rain Drain - eadi additional 100' 25.00
Mobile Home Space 25.00
Engineer CitylState Zip Phone Co Device Flow Prevention Device or Anti- 25.00 -
Describe wok New 0 Addition 0 Alteration 0 Repair a Residential Beddow Prevention Device' 15.00
to be done: . Residential 0 Non- residential 0 Any Trap or Waste Not Connected to a Fixture 9.00
Additional description of worts r Catch Basin
c> •�`c f r r c k E/�G�t °IC 9.00
f 11„,g,7? ii? Gr1 fr14` �� ! Insp. of Frosting Plumbing
40.00
X24, S• ,,'L • per/hr
Existing use of / Specially Requested Inspections 40.00
budding or property (- i% 1i^./!1J? t 1 i` per/hr
Rain Drain, single family dwelling • 30.00
Proposed use of / %' y N -W: / t' Grease Traps 9.00
building or property i . 0 , ! ,� 1
1 t • '\ -
QUANTITY TOTAL r
•
Are you q moving or replacing any fixtures? Yes (D No p day= n is required d Ohrarhity Total is > 9 ,i;:;7.-:,'ii:: , y 1.
Y capping . mo Isometric or rise
{if yes see back of form) 'SUBTOTAL _ _ ° ;•
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
that plans submitted are in compliance with Oregon State Laws.
_ .-
_.,
Si turn o • Date PLAN REVIEW 25% OF SUBTOTAL - - ' T.i:'-
f Required only if fixture qty. total is > 9
G V �`" TOTAL
• arson Name Phone
`�" � l /� G � �� - Minimum permit fee is 525 + 5% surcharge, except Residential Backflow
L(/ �Yl Prevention Device: which is 515 + 5% surcharge
I: \plmapp.doc 12196 (dst)
'LEASE COMPLETE AS APPROPRIATE TO PROJECT:
I Fixtures to be capped, moved or replaced Qty
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)
;OMMENTS REGARDING ABOVE:
I:\plmapp.doc 12/96 (dst)
A — CX-- (2 -4-/ ) 1L3j2
CITY OF TIGARD BUILDING INSPECTION DIVISION • • e (7
24 -Hour Inspection Line: 639-4175 Business Phone: 639 -4171 I
S \ 9^7 1
Date Requested: A.M. P.M. MST:
Location: / C) `7' U 7 /, / A i •--Q .-' BUP:
Tenant: Suite: Bldg: MEC:
. ' Contractor: Phone: PLM: ! 1 I C 4(
Owner: k 0 G':511 2-4 l.C� -P_t2J Phone: (9 " 2 3 ELC:
�S �. i. ♦�a t h 7 „ �• a . Ya . �, r. ��.•+ Yr 'cr a • .
_�� 1.a P an 1,�., .7 � 2E / . T r t l
�j_•r• L.. .1. lift' , a.� 0 .1 " x ^ � r � ' i. � �i ;.• 2't� ._i ,.. y. } .�r ,��
• 7 . ce• o f + . {� .` c 4 rb -r i, i - ELR:
cif, �4,a �(` � � s a��C��/5� -.-.� �' y. ; wT�,�,? x��u'.�� � ti ��•t Y' �_•�
, ..� 1.. ' r99d 1.��fi e� t R .Y �_J: ,.4S Le C . 1 , 4 '',",•;, _'_.Y /31_ " . -N ?� �c 4 ---:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE .
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling - Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer t • Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not A proved Not Approved Not Approved Not Approved
FINAL /'FIN FINAL FINAL FINAL
_ A
(/)4 )� $ Ar qk✓�' , /1 c_crc-a n ail A 7 t HAe 1' ••
C% , c :II 1S 15 If 1 ,1 'sLo S 1 4/ AS N i IL 1- 00 i
le�4 ..g' /Li (d 4 - 0 4N./ ,C t 1,,. (l . 10 - A et i- /IJ M l/ ie h kii 0 Yr)
1
A 6 / /4 D itC1 0 1-4 ec9 vi 16 iQ
7)
1
•
'.0 ,Call for reinspectio O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector// a, A (YV4LLDate: YY l ar I 'I Page of
5/10/00 Activities for Case #: PLM97 -00164
1:03:04 PM EXPIRED
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMA007 Application received 5/7/97 5/7/97 JSD PASS JD 5/7/97
PLMA011 Create Permit 5/7/97 5/7/97 JSD PASS JD 5/7/97
PLMA740 Misc. Inspection 5/7/97 8/25/97 LP2 FAIL J *H 8/25/97 Water heater access blocked by
stacked washer & dryer. Move
and request a reinspection.
PLMA799 Final Inspection 5/7/97 JD 5/7/97
PLMA050 (F) Issue permit 5/7/97 JSD PASS JD 5/7/97
PLMA845 Request inspection research 3/28/00 JMT DONE No Hold JMT 3/28/00
• PLMA850 Expired by limitation 4/18/00 HAP DONE No Hold AKJ 4/18/00
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