Permit 'f` CITY OF TIGARD PLUMBING PERMIT
r DEVELOPMENT SERVICES PERMIT #: PLM1999-00266
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/10/1999
SITE ADDRESS: 10751 SW 130TH AVE PARCEL: 1S133AC -KNOW1
SUBDIVISION: KNOWLEDGE BEGINNINGS DAYCARE C ZONING: R -25
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 25 TRAPS: 0
STORIES: WATER HEATERS: 2 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 21 URINALS: GREASE TRAPS: 1
LAVATORIES: 10 OTHER FIXTURES: 3
TUB /SHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: 18 WATER LINE: 100 ft
DISHWASHERS: 1 RAIN DRAIN: 100 ft
Remarks: Plumbing for a new basic commercial building. Other fixtures are 1 service sink and 2 drinking fountains.
FEES
Owner:
Type By Date Amount Receipt
HULSEY DEVELOPMENT CO PRMT BON 11/10/199c $1,060.50 99- 319698
PO BOX 8600 PLCK BON 11/10/19a $265.13 99- 319698
BEND, OR 97708
5PCT BON 11/10/1995 $74.24 99- 319698
Phone 1: 541 - 385 -9285 Total $1,399.87
Contractor:
MARXMEN PLUMBING INC
9665 SW 163RD AVE
BEAVERTON, OR 97007 REQUIRED INSPECTIONS
Phone 1: 579 -2200 Sewer Inspection
00102432 Water Service Insp
Reg #: LIC 00 Underfloor /Underslab
PLM 34-161PB 32
Top-out lnsp
Storm Drain Insp
RP /Backflow Preventer
Final Inspection
OR
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Glt,((Z— Permittee Signature: ,
Call (503) 639 -4175 by 7:00 P.M. for an inspection nee. • he next business day
, G$/ _ _ WED 15:46 FAX IZj o02/0o3
1909 1:17P FROM STEELE SOCIfTES _ 385 8816 P.3
/ //! /1Z-1(/11
• CITY OF TIGARD - U n ermit Application Plan cheats 1 r7
' 13125 SW HALL BLVD. Commercial and Residential Reo'd By G. .
TIGARD, OR 97223 Date Recd 2/5 ftiq
(503) 639 -4171 Date to P.F. 'Ii / 1
. Print or Type Date to DST IQ f
Incomplete or illegible applications will not be accepted Permittt �� �f�'Y zF
Related sWR 0 l qfq "Oa i' 75
Called
Name of Dov,lopment/Project FIXTURES. :.(Individual) ... '. :tire , I PRICE ' AMT
• Job rav1� R iciAt Sink .... ' ti, 2I �co ;ii ,s
• Address Street Address irk uite Lavatory V I_b $,110. t/S
10 7S 5‘d 1 S l30 Tub or Tub / Shower Como. 9.00
Bldg t Clly /State Zip
j p (n 17 z 3 Shower Only — Y r I 9 .00
-1 �r> � - Water Closet +� - ,107,
j� , (� 0o
4 L51 l)ei,6 j 60 Dishw her • V I t _SAO. /1.50
Owner L :) 1056 Suite Garbage Disposal 9.00
Waiting Machine , V • t Leo" i 5c
City /State 4 p Zip Phone S Floor Drain/Fleor Sink 2' 2q -gm" ,27 L• °e
i
FJrtrl rjan d' S 9,00
Occupant Mailing Add Suite Water Heater 0 conversion 0 like kind IV z ..4.ee-
Gas piping requires a separate mechanical permit. 0 23. 60
City/Slete Zip Phone Laundry Room Tray 9.00
Urinal 9,00
Name l/t 4 QX M e i� In CIA m 1g h)J 6 Other Fixtures, (Specify) 9.00
Contractor Mailing Address f � Suite �{�I/ fe ( t rry� z / I -P'� /5•�
9,4,5 ,�``, /6 3��1 f.., i ��i �uYl i ii ✓ 2 s,eo' �a . 00
Prior to permit. ty�(stat Zlq, Phone Sewer- tst - 180' �.�err 7 l
issuances, a copy 1511/T � 1 k 7 re)? 571 -� .7Gt7
Sewer - oath additional 100' 25.00
of all licenses are Oregon Const, Cont. Board Lic.# E Date
'
required if /0 oZ cf 3 '2 — /7- 7.O/ Water Service - 1st 100' 1 -Awe 3g, 0
expired in COT Plumbing LAC. # p Exp. Date Water Service - each additional 200' 25.00
database 3 /Co/ i / - 7l Storm & Rain Drain -1St 100' -3040- 3 0�
Name Storm B Rain Drain - each additional 100' 25.00
Architect E1 -a , heat, T A Mobile Home Space 25.00
or Medi Address Commercl Back Flow Prevntin Device or AMU" 2500 Vile 10 Pollution Device
Engineer Cl /State o 1 '7 Zip Phone t Residential Backtlow Prevention Device 15.00
, ,{rn OK 39 ( 34 q "Pin (Irrigation tinting devices require a separate J
Des 'be work to b �, done: . reatrl tG0 onetgy permit.) .
New Repair 0 Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture � 9.00
Res ial 0 Cgntmerdal Catch Basin 9,00
Additional description of work:
• Insp. of Existing Plumbing 40.00
• per/hr ;
-
Specially Requested Inspections 40,00
per /hr 1
Are you capping, moving or re lacing any fixtures? Rain Crain, single family dwelling 30.00
Yes 0 No Grease Traps 1 -940- 115) 1
If yes, see back of form to indica work performed by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser Aiagram a required ir Quantity Total L > 9 85
WORK COULp RESULT IN INCREASED SEWER FEES. 'SUBTOTAL ' ' , i
I hereby acknowledge that I have reed this application, that the information :' '
given is correct. that I am the owner or authorized agent of the owner, and 5% SURCHARGE
.4= . submitted are in cote -li ce with Oregon State Laws. 7y�U
si "PLAN REVIEW 25% OF SUBTOTAL '.
�r / Date R 6gWr® only M1REJ (Orel IS 9 • i�la 4 �r / TOTAL ' /397:37
Contact Person Name Phone Spa
- Minimum permit fee is $25 + 5% surcharge, except Residential Baekflow
O 3i;4'S� L! Prevention Device, which is $15 + 5% surcharge
All New Commercial Buildings require plans with iaometric or riser diagram
i and plan review
Cu P/�q9-
�_
l.1d9sVorms1olurnapp.9oc 1orasraa
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM y PM BLD
Location ; : Suite MEC
Contact Person • l Ph PLM ,
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing .,, �rlr; �„� ►�� ^'�r� 4i's o:pwtr i�i�: �; a.�.o� "t
Foundation « c�` 5;,�� fc C j'! :v ' 7 <� ��� �" :v ,. .l , l - :Af.e FPS
Ftg Drain 'y� � ,;,e..; * ,�?�. -?o•; ' ' °j ='; " r'Ii,% '" • ;6'1: ='�
Crawl Drain Inspection Notes: SON
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler / �- . .0>i ALi4/r___
Fire Alarm //./ f
(2? Susp'd Ceiling / r
Roof 4101
Misc:
Final
PASS _ PART FAIL
Posf beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Ra' . Drains
PART FAIL
CHANICAL
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
ADAroach /Sidewalk Date (26/6'
U Inspector j7 �t/ Ext
Approach/Sidewalk /
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
04/28/2000 Activities for Case #: PLM1999 -00266
8:46:46 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 08/05/1999 GEO RECD No Hold GEO 08117/1999
PLMC005 Permit Created 08/17/1999 GEO DONE No Hold GEO 08/17/1999
PLMC007 Plans routed to Plans Examiner 08/17/1999 GEO DONE No Hold GEO 08/17/1999
PLMC000 Commercial Menu 08/23/1999 MRS No Hold MRS 08/23/1999
PLMC008 Plans Approved /Routed to DST 08/23/1999 08/23/1999 09/09/1999 MS SENT No Hold MRS 09/08/1999
PLMC120 Plumbing Undersl 08/23/1999 08/23/1999 No Hold MRS 08/23/1999
PLMC705 Sewer Inspection 08/23/1999 08/23/1999 No Hold MRS 08/23/1999
PLMC711 Water Service lnsp 08/23/1999 08/23/1999 12/14/1999 TLP PASS No Hold TLP 12115/1999
PLMC720 Underfloor /Underslab 08/23/1999 08/23/1999 12/10/1999 MRS PASS No Hold MRS 12/10/1999
PLMC725 Top -out Insp 08/23/1999 08/23/1999 02/17/2000 MRS PART No Hold AKJ 02/17/2000 1) no test on waste
2) water test ok
PLMC730 Storm Drain lnsp 08/23/1999 08/23/1999 02/02/2000 MRS PASS No Hold MRS 02/02/2000 9 rd's to bldg
PLMC750 RP /Backflow Preventer 08/23/1999 08/23/1999 No Hold MRS 08/23/1999
PLMC799 Final Inspection 08/23/1999 08/23/1999 04/24/2000 MRS FAIL No Hold AKJ 04/24/2000 1) need to put a piece of pipe
on your discharge and comp sin
2) soaking sink must go indirect
to a floor sink
3) dishwasher must go indirect
PLMC015 DST Post Review Complete 09/14/1999 DEB DONE No Hold DEB 09/14/1999
PLMCO20 Hold for 09/14/1999 DEB DONE No Hold DEB 09/15/1999 Hold for conditions of approval
on CUP1999- 00002. Must
identify contractor.
PLMCO34 Hold Release to Ready Status 11/10/1999 DEB DONE No Hold DEB 11/10/1999 Okay to issue per PLN & ENG,
must identify contractor prior to
issuance.
PLMCO50 (F) Issue permit 11/10/1999 BON DONE No Hold BON 11/10/1999
PLMC711 Water Service Insp 12/28/1999 12/28/1999 12/28/1999 MRS PART No Hold MRS 12/28/1999 water service run to bldg needs
to be tested
PLMA711 Water Service Insp 01/03/2000 01/03/2000 01/03/2000 RB FAIL No Hold RB 01/03/2000 Less than 50#- No inspection
made.
PLMC725 Top -out lnsp 02/22/2000 02/22/2000 02/22/2000 TLP PASS No Hold AKJ 02/22/2000
PLMC799 Final Inspection 04/26/2000 MRS PASS No Hold AKJ 04/26/2000 1) bfd OK
2) need to dig out under device
1"
PLMC800 Case Finaled 04/26/2000 AKJ DONE No Hold AKJ 04/26/2000
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