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Permit I CITY TIGARD PLUMBING PERMIT ''I DEVELOPMENT SERVICES PERMIT #: PLM2000 -00319 „ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/25/00 SITE ADDRESS: 10255 SW 90TH AVE PARCEL: 1 S135A6 -00100 SUBDIVISION: TOWN OF METZGER ZONING: R -4.5 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: CMS WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: El 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: 38 ft WATER CLOSETS: WATER LINE: 38 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of 38' of sewer line and 38' of water service for new modular school building. FEES Owner: Type By Date Amount Receipt TIGARD- TUALATIN SCHOOL DIST PRMT CTR 8/25/00 $76.00 27200000000 13137 SW PACIFIC HWY 5PCT CTR 8/25/00 $6.08 27200000000 TIGARD, OR 97224 Total $82.08 Phone 1: Contractor: BERRYHILL BROTHERS EXCAVATION 20897 SW SCHOLLS - SHERWOOD RD SHERWOOD, OR 97140 REQUIRED INSPECTIONS Phone 1: 628 -3891 Sewer Inspection Water Line Ilion Reg #: LIC 00062191 Final Inspection 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 . y: ,� ,d d ' Permittee Signature: Ari Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day , CITY OF TIGARD Plumbing Permit Application ' Plan eck# 13125 etty HALL BLVD. Commercial and Residential Rec'd\By r TIGARD, OR 97223 Date Recd R-,9 (503) 639 -4171. . Date to P.E. ------ Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit #�talt -rya t 9 Related SWR # Called N e of DevelopmenUProj t c 1 FIXTURES i �" �a "'` _ ; �/ `I � �_ I z .� r�_.. ,.�. -�; (ndividu I ), , �<< ~;e��i: . ���: ; G2�T�Y >�<�,3F?RiCE'� AMTS Job O f W-e V fit ( !/Lc � j Sink 11.50 Address Street Address 1 Suite I Lavatory 11.50 (e,"2-- C S c4) %A vg Tub or Tub /Shower Comb. 11.50 Bldg # Cit /State , Zip d // © q 7223 Shower Only 11. 11.50 50 e / ater Closet IC -TUti . �[- 7 14�V(a Si g Urinal . 11.50 Owner Mail(ig Address - . Suite Dishwasher 11.50 i ?it 37 ') DcC I / Ci / State Zip il l Phone Garbage Disposal 11.50 t f d at 9 `f 3 / -WCPSO Laundry Tray 11.50 Nam /_ Washing Machine /Laundry Tray 11.50 a bs Floor Drain /Floor Sink 2" 11.50 Occupant Mailing Address Suite 3" 11.50 City /State Zip Phone 4" 11.50 Water Heater 0 conversion 0 like kind 11.50 ' / �f _ / Gas piping requires a separate mechanical permit. N eh'ti f4 51. - ei . " (i„,. va �01..A_ MFG Home New Water Service 32.00 Contractor �im4ss d ; 1 Suite MFG Home New San /Storm Sewer 32.00 , 2uvdia,-1. Hose Bibs 11.50 Prior to permit Cit /State Zip Phone wrpp -( Roof Drains 11.50 issuance, a copy 5 .) ?/LID Drinking Fountain , 11.50 of all licenses are Oregon Cost. Cont. Board Lic.# Exp.,, required if & 4 I to / D Other Fixtures (Specify) 15.00 expired in COT Plumbing Lic. # Exp Date database Name Architect Sewer - 1st 100' . or- Mailing Address Suite 38.00 3 Sewer - each additional 100' 32.00 __,, Engineer City /State Zip Phones Water Service - 1st 100' SO 38.00 Sr.0 Water Service - each additional 200' 32.00 Describ cork to be done: Storm & Rain Drain - 1st 100' 38.00 - New Repair 0 Replace w" Ike kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00 Residential 0 Commercial Additional description of work: Commercial Back Flow Prevention Device 32.00 Residential Backflow Prevention Device* 19.00 . • Catch Basin 11.50 Are you capping, moving or repIac any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 Yes 0 No (9' Inspections per /hr If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL `"ECi "' i ` ''`' "°-h` `° I hereby acknowledge that I have read this application, that the information ° �� :, Y 9 PP ,, n= y,. given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required if Quantity Total is > 9 <,. ";_ that plans submitted are in .mplia.ce with Oregon State Laws. *SUBTOTAL " 7, z , ; ." '7� ,C0 Sign of Owner /A• • � Dat ` av ,/1.0.4.a_ / `r 7 S / Oa 8% SURCHARGE v '`,WA . /_ it Co t Person Na Phone "srkd (1.t vie � e �i t i // ( off $ � J / * *PLAN RE VIEW 25% OF SUBTOTAL '» � 4,tf; 1 =BATH.HOUSEt$1,78 00 '' ""a,"3. ,; " ;;,� " l Required only if fixture qty. total is > 9 :.. � "'" TH ''H : -' ''' O a w %: ; `, ` ' i 7 ' ' r woo I TOTAL' (727 64 HOUSE$2 r:. -. t r y ` . ,= ' " �:: .;y. °' Thisfe a cludes=ali lu mbin �flztures i n.tt e ,dweIhng he °fl' t ?`zx - ` ,�- e " " " =v�� " ��;�<�,_� °.a;�; - =_ , �, �;, �.,- �< �., -;, � ,- ;z- ,,;� ° „ "�9r:,, � "��;� *Minimum permit fee is $50 +8% surcharge, excepfResidential Backflow Prevention i ; 100 -feet; of; s a n rt a 07* 6r, ; st_ o: an d wa t er serv . y . , Device, which is $25 + 8% surcharge **All New Commercial Buildings require plans with isometric or riser diagram and plan review. I:tdststformstplumapp.doc 11/18/99 r � i •. PLEASE COMPLETE: rte' 7 `uan i� �" t gib° �1Nork Pe or Y t' : =Q rf med ym pry Yu - ;�. New�,F N , M .a Y .. oved.. Re -faced °;`Rem o� e d/C � � a Y+ t: � �.�. ed Sink Lavatory Tub or Tub /Shower Combination Shower Only • Water Closet Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Floor Sink 2" 3 " 4 " Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I: \dsts \forms \plumapp.doc 11/18/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested -' ( AM PM BLD Location (t 2.-.5") 5 9'0 25:c /pi Suite MEC Contact Person 12UU1 Ph 2'f— V3 3 2 PLM 0,7liOU f 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 Misc: Final PASS PART FAIL LUMBIN Post & Beam Under Slab Top Out Water Service rigvANtlaii jifJ Sanitary S ar.—> Rain Drains Fina i gni PART FAIL M NICAL 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 D 9 — 7 ` Qd Inspector Ext 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 g — 3 / AM PM BLD Location /O, 5 5) 9o4 iv (.5'ae,")Suite MEC Contact Person Ph 2,01 — ¥ 3 3 Z PLM iav - 0 3 ( �' 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 Misc: Final Fina _ • _ RT FAIL Post & Beam Under Slab e,6 �� 1 Top Ou o tatirerlIP �_n� ary Sewer? Th}2 Rain Drains Final PASS PART FAI 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 [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [kKase call for reinspection RE: [ I Unable to inspect - no access ADA Approach /Sidewalk Other Date 4e- e d Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING IN SPECTION DIVISION f - MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 71 �/ BUP Date Requested F eJ AM PM BLD i Location / (72.55 5 kid) f0 40. ( Suite MEC Contact Person Ph PLM 2 ' - D U Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access : ` Gr� FPS Foundation Ftg Drain �/ SGN Crawl Drain Inspecti o 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 LUMBING) Posl3eam Under Slab Top Out <Water Service - Sanita ewer s - _ Rain Drains Final ,/` PASS PART IFAI 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 k t 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 y r • 7;\ v i' Approach /Sidewalk ( * i••✓ i� Date Inspector Ext �. _ Other �' Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site