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Permit r Y •• CITY TIGARD PLUMBING PERMIT 1l DEVELOPMENT SERVICES PERMIT #: PLM2001 -00294 „��l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/12/01 SITE ADDRESS: 13345 SW 129TH AVE PARCEL: 2S104DA 04300 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 -- BLOCK: LOT: 029 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 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: Installation of backflow preventer. FEES Owner: Type By Date Amount Receipt DEBISSCHOP & COMTOR PRMT CTR 7/12/01 $36.25 27200100000 13590 SW 31ST ST 5PCT CTR 7/12/01 $2.90 27200100000 BEAVERTON, OR 97008 Total $39.15 Phone 1: 503 - 641 -4541 Contractor: OWNER REQUIRED INSPECTIONS Phone 1: RP /Backflow Preventer Final Inspection Reg #: 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- 987. • ApH Issued By: /��L` Permittee Signature: a sk , , 1 .A.3; :Q � , . NM/ " r Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business da 6 , 2-s' .4 a- . , V Plumbing Permit Application Datereceived:� /z /p / Permit no. m � -)aC� City of Ti and 1G � `J g Sew permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, 0 97 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 -1960 Date issued: By: j Re no.: Land use approval: C ase f ile no.: Payment type: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Food service LI Other: JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist) Job address: / 53 (..7 J kJ /1 (, 1/.L • 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: a 9 IBlock: I Subdivision: 0V' a 2 /4/7G%..../ 1.^ W(2) bath Project name: SFR (3) bath Cit /count '' Y Y T 5A,, j d. � � ZIP: g 7 ZZ ,3 Each additional bath/kitchen _ Description and location o work on premi Site utilities: Z 3 cc Li , /6y -1^-/ Catch basin/area drain Est. date of completion/inspection: Drywells/leach line /trench drain 5; PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: Manholes Address: Rain drain connector City: ,, I State: I ZIP: Sanitary sewer (no. lin. ft.) _Phone: —� Fax: I E-mail: Storm sewer (no. lin. ft.) CCB no.: I Plumb. bus. reg. no: Water service (no. lin. ft.) City /metro lic. no.: Fixture or item: Absorption Back valve Contractor's representative signature: Back flow preventer f § .a '3( Print name: Date: Backwater valve CONTACT PERSON Basins/lavatory Name: 3 K.( -GCv, 'J-/ i2, f0"/ Clothes washer • Address: 1 Dishwasher Drinking fountain(s) City: I State: I ZIP: Ejectors /sump Phone: M 01 -37 93` Fax: E -mail: Expansion tank OWNER Fixture /sewer cap Name (print): fl d el9 e esi t,ht grad d CarultY Floor drains/floor sinks/hub ad dress: is e f}� Garbage disposal Mailing 1 �7'3J� 5 Hose bibb City: f i� /i i d I State: 00 I ZIP: 8 722-3 Ice maker Phone: • 7 -57g-379 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 prope m .�:• wn .. per ORS Chapter 447. r Sink(s), basin(s), lays(s) Owne s st_' : t i ` 7:;1 .� i '.! Date: 7 J PI Sump ENGINEER , Tubs/shower /shower pan Urinal Name: Water closet Address: Water heater City: State: I ZIP: Other: - - Phone: I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $ �a 1' ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ 4 a Expires TOTAL $ ? J 4 /- / 5 Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440 -4616 (6/00 /COM) PLUMBING PERMIT FEES: , PRICE ' ---',TOTAL- ,,,-.' FIXTURES (individual) - `_'. ' I '':,., .:37 ' : QTY ,leai. ,,,' AMOUNT., (includes all 010610g:pictgi - ' PRICE: %, ,- I.9:1#k- Sink 16.60 ,:ifie - ' :- QTY (ea) AM011ts1V, Lavatory 16.60 :totreadti utility - riii - ‘,6064.4 .., . . ,: .', 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 3" 16.60 PLEASE COMPLETE: 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 .Z , =Quantity'bli WorkReifornied - - Gas piping requires a separate mechanical Fixture Type: • :Nevi' Moved ,. Removed/ I permit. ' ,-,6'.' :,''': - , ,Z 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 - 1st 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* (D 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 8% STATE SURCHARGE .- „' . . • 'PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total is >9 TOTAL i * Minimum permit fee is $72 50 + 13% state surcharae, except esidential Backflow Prevention Device, hich is $36.25 + 8% state syrcharge. ** All New Commercial Buildings require p ans with isometric or riser diagram and plan review. i:\dsts\forms\plm-fees.doc 10/10/00 ' ' CITY OF TIGARD BUILDING INSPECTION DIVISION y • 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST a BUP Date Requested 7 y AM PM BLD Location / 3 3 cis /2-' 1 ✓ // Suite MEC Contact Person a 7 / s 4 °p Ph 3• 57,- f ?y PLM --002 c J y 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 Framin /Shear 1 � �� � J� / it r J * �� n( � a v -ri � � Framin J t / / Insulation Drywall Nailing 7)R.V/( Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART • FAIL PLUMBIN � . m Post & Beam Under Slab Go Gc./C Top Out Water Service Sanitary Sewer. Rai, D rains 4=0 PART FAIL ∎∎•∎119. — • ICAL 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 - ' — I 7 _ Q / Inspector 7Y/ / /gv-c E 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 7 AM PM BLD Location / 57(1 5 IAl /2j « /- " Suite MEC Contact Person Ph 57,--3773 PLM 2e.rL /- 2() Z� y Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Q (A Cc ( SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear c / Framing ' j rr-ov / r X' ? i'/ e d/ 7(4 d f-e_ �7 Insulation / / Drywall Nailing f ? e l / 70 / [ G “e 71/L. Firewall � Fire Sprinkler �r,0 V !/� . lr7 �� 2 �-ecr- - ro pt Cl 7` co C•t_. Fire Alarm Susp'd Ceiling 'r J '� 7l® Ur��C� 2 C I -f v c i 714.344A,.. Roof �' r Misc: ./ q ` i� p ct /ins S i '°S 7)C5?-741 Final l C • h 4 / PASS PART FAIL / 7 ,' " c 250 x r r O u 7)P v/ `.2 - a c/f LU t' ,) 7 rvv ji 7 Grav-e 44 a,. Post & Beam / T 9 Under Slab belt 77 L CI S /9 (/ �1'// C�-& I cf � `� � »bl oP Top Out Water Service d' PQ V) C am. S 71- Ca ..Q Q L., /1 .PC Sanitary Sewer Rain Drains - Y e f p,, ;/ N tic bed 7 , Final • PASS PART . IL 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 / - ph oach /Sidewalk r Date � � / v / Inspect / / / C- V'e E Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . . BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By j 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 NI Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing � Inspection Description Date Passed By _ Post /beam mechanical Suspended ceiling Gas line Engineered soils Welding Lab Final Mechanical rough -in Fire damper Concrete Lab Final _ Duct work Bolting Lab Final Smoke detector Structural observation — Mechanical final Fireproofing Lab Final Final inspection PLM - Plumbing Permit . Sw 4 Inspection Description Date Passed By BUP — Fire Protection System Permit 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 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 1— di( Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 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 CITY TIGARD PLUMBING PERMIT 4,a;- ,pr ti DEVELOPMENT SERVICES PERMIT #: PLM2001 -00294 DATE ISSUED: 7/12/01 --' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13345 SW 129TH AVE PARCEL: 2S104DA 04300 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5 BLOCK: LOT: 029 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 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: Installation of backflow preventer. FEES Owner: Type By Date Amount Receipt DEBISSCHOP & COMTOR PRMT CTR 7/12/01 $36.25 27200100000 13590 SW 31ST ST 5PCT CTR 7/12/01 $2.90 27200100000 BEAVERTON, OR 97008 Total $39.15 Phone 1: 503 - 641 - 4541 anild Contractor: OWNER REQUIRED INSPECTIONS Phone 1: RP /Backflow Preventer Final Inspection Reg #: 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- 987. Issued By: � � L AP Permittee Signature: ak, , (;;1; :�.,�'���_ Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business da •