Permit CITY TIGARD PLUMBING PERMIT
�,Y DEVELOPMENT SERVICES PERMIT #: PLM1999 -00224
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/23/99
SITE ADDRESS: 11865 SW 91ST AVE OFFICE PARCEL: 1 S135DC 02000
SUBDIVISION: VILLA LA PAZ ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R1 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: 500 ft • DISHWASHERS: RAIN DRAIN: ft
Remarks: 500' of water service
FEES
Owner:
Type By Date Amount Receipt
VILLA LA PAZ LTD PARTNERSHIP PRMT BON 7/23/99 $102.00 99- 317119
COMM PARTNERS FOR AFFORDABLE MISC BON 7/23/99 $7.14 99- 317119
PO BOX 23206
TIGARD, OR 97281 Total $109.14
Phone 1:
Contractor:
APOLLO DRAIN + ROOTER SERVICE
2208 NW BIRDSDALE #8
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Phone 1: 239-8801 Water Line Insp
Reg #: LIC 00049418 Water Service Insp
PLM 26 -533pb Final Inspection
ORIGINAL
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 -0
You may obtain copies of these rules or direct questions to OUNC by c ' g (503) 246 -198
Issued By: , / I Permittee Signature: iski A 4 1.
Call (503) 639 -4175 by 7:00 P.M. for an inspection neede e n xt business day
•
CITY OF TIGARD Plumbing Permit Application Plan Chec #
13125 SW HALL BLVD. Commercial and Residential Rec'd By
'TIGARD, OR. 97223 Date Rec'd 1 -
(503) 639 -4171 Date to P.E.
•
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit# 11jJ 1tq`fiy DU7"'Zi/
Related SWR #
Called
FIXTUR <:(individual) ` ;;. Q� .-PRIDE
Name of D veto menUPro ect = > ' � - -�� ��
1 /
Job V I ( ( A ,L k I 14 Z Sink 11.50
Address Stree ddgS� 5-to-40e O �. Lavatory
Tub /Shower Comb. 11.50
(��� Bldg # Cit /State A Zip
/`2- 1 , � _ +- ( Shower Only 11.50
r> Water Closet/Urinal (Specify) 11.50
V ` \ G� Lk �� ? L l l ' l Dishwasher 11.50
Owner Mailing Address Suite Garbage Disposal 11.50
Washing Machine /Laundry Tray (Specify) 11.50
City /State Zip Phone Floor Drain /Floor Sink 2" 11.50
Name 3" 11.50
(( 4" 11.50
Occupant Mailing Address Suite Water Heater 0 conversion 0 like kind 11.50
Gas piping requires a separate mechanical permit.
City /State Zip Phone MFG Home New Water Service 28.00
MFG Home New San /Storm.Sewer 28.00
Name ,77// d
O �, . I � Hose Bibs 11.50
Contractor Mailing Ad ess / Suite Rain Drains 11.50
7-72-61$ J Q-H-b Drinking Fountain 11.50
Prior to permit C'ty /State Zip Phone Other Fixtures (Specify) 15.00
issuance, a copy. C 6Q- q--10 % v gD(
of all licenses are Ore n o t. Cont. Board Lic :# Exp. Dat Az
required if l-� � i (II 171
expired in COT Plumbing Lic. # Ex p. Dat
database -- `j?j, -(0? (1` -�1 - ��
Name V Sewer- 1st 100' 38.00
Architect . Sewer - each additional 100' 32.00
o r Mailing Address Suite Water Service - 1st 100' j 38.00
En ineer City /State Zip Phone Water Service - each additional 200' Z 32.00 OY tZ
g Storm & Rain Drain - 1st 100' 38.00
Describe work to be done: Storm & Rain Drain - each additional 100' 32.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 Commercial Back Flow Prevention Device
Residential 0 Commercial 0 Residential Backflow Prevention Device* 19.00
Additional description of work:
Catch Basin 11.50
Insp. of Existing Plumbing 50.00
Are you capping, moving or replacing any fixtures? per /hr
Yes 0 No O Specially Requested Inspections 50.00
• If yes, see back of form to indicate work performed by per /hr
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain, single family dwelling 45.00
WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50
I hereby acknowledge that I have read this application, that the information QUANTITY TOTAL i '' "'n-c 1 '''%
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 S ,�
*SUBTOTAL that plans submitted are in compliance with Oregon State Laws. � LL
�� .s� > : x. .
Signature of Owner /Agent Date w
7% SURCHARGE _ : shN IyI
Contact Person Name Phone - �. � "
**PLAN REVIEW 25% OF SUBTOTAL r ":X .'`; ', r,
=1 B4TH=HQUSE($170404 -7 '� :11 ; T. <.', ,_ Dui Required if fixture qty. total is s -" ,
� �_ _ � � q Y q Y _ s
2 B ATH HOU 00 - ` ; j-- ; * = T OTAL
3 BA HoIJSEY$285 0 0 a i .� - = kt".
<; * _ fi r. - ' . .•�,
few sT fiis�,fee'incl u des all lumd "in 'fixtures,in a n d .ttte'fi i t t,
-- .01 :04. _; %4t eg : _ . ^. -- -• > °^• ,� r a-4 = „°..- s: , ! -: a 'Minimum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention
OOfeef, ofsanitacy sewerstorm sewer an 4 w ater> service)-:, ; -; ;, ,a• - 3, Device, which is $25 + 7% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
I: \dsts \forms\plumapp.doc 7/19/99
•
PLEASE COMPLETE:
UI Ii rey p� ,'" ;11
A.P - Pitr
kilVI9Xeckt!T: ;' R as PPR
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain/Floor Sink 2"
3 „
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I: \dsts\forrns\plumapp doc 7/19/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
"3 " - '9 7 Date Requested 9 / — 9 AM PM BLD .
Locatiofi / /g,o.' Sc.- y /,s 7 ,ij' ° _ J6 (a ,c) Suite MEC
Contact Person 'l�G moyl A � is,�e ,i ,_ . Ph PLM fy'9y -00221
Contractor / / / 0Y. 1/) Ph RV,..- Ps - %y SWR
BUILDING Tenant/0 r C
Retaining Wall EL
Footing Ac ss:
Foundation 5 r N� (/- / 4 F
Ftg Drain / �i' � Z�
Crawl Drain In pection Notes: _ ' SGN
Slab @ / �f SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm // .
Susp'd Ceiling X // / /.91 -i� 7 _r�G a � l; /3 y
Roof
• / / � � '�` f ,,, / ' �`- .1
Misc: rte—
Final 76 �-(C..) ,e Cu 2 / �� Z--e'�
_Ep[? FAIL
LUMBLING___- N Z-1 4 1 Z-4-7 ' 04 1 -. , A -71 / IS P-1,,,), / p i Eii-t 7
Poste`& -Be \
Under Slab 0 !� CO f ifs 7 6 /i ,
Top Out
Water Service
Sanitary Sewer /
ai Drains .3-' : C&alY a / / 1-
final '
PART FAIL
j
/,✓�6 /� % G
M 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 --77
O t he oach /Sidewalk
Date 2 Inspector 7 Ext
Final
PASS PART FAIL DO NOT REM VE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q BUP
Date Requested AM PM BLD
Location I I , Lc '1 I S + �" V'C� Suite 6e, MEC Q
Contact Person �.J YYLOAd Ph ?,3q' S RO I PLM I 9 — CO22J - 1
Contractor ' 1 Ph SWR
BUILDING, Tenant/Owner U (1 ( . 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 7— — P / 1/
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
<PLUMBIO.
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
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
Other Date 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 7- 2-7° Y Y AM PM BLD
Location J��� , Suite MEC
Contact Person Ph PLM /77? 0e> I L
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
PLUMBING •t / 410
Post & Beam /�dwi
Under Slab
To O .�
Water Service
a ewer
Rain Drains . y i•. _��!�
Fin- � /�`
4 0, FAIL
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
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 - -1/
Other Date Inspector 2/7/7 Ext
Final •
PASS PART FAIL ''O 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
D ate Requested S —3 -I' AM 6144e PM BLD
Location l ( <8 S Ski-( Suite MEC
—
Contact Person • ( 1-4..J AL_ Ph .v PLM l qq9 - Cr)Z2t1
Contractor \ Ph SWR
BUILDING Tenant/Owner \) A I ( OL. I � 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 7 ,i
Fire Sprinkler ) / 1 .
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL a 41"
Post & geam
Under Slab
To Out
ter Ser`vl�o>
Sanitary Sewer
R -i Drains
FAIL
CHA • L
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA — ,f
Approach /Sidewalk U
Other Date Inspector ' 27? E
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
j BUP
Date Requested R-4- ! AM PM BLD
Location l L p(O S " 1 , S A A _ ,� �,/ Suite MEC
Contact Person YYWY 6( Ph Z � / 8 p gdi PLM i ! C � 9-00 22
Contractor . Ph S(big- -isq SWR
BUILDING Tenant/Owner U I 1 ( L& PA:2_ 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 t 7 /
Firewall 1 40' Fire Sprinkler / ifW
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final '�i . r '
PASS PART FAIL •
Post & Beam
Under Slab
Top Out
meter Serve
Sane ary Sewer
Rain Drains
(0 /0 FAIL
CHANTCAL
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 Date b "6 I Inspector 7 7? Ext l �
Other
Final
1 PASS PART FAIL DO NO 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
q BUP
Date Requeted �''[� . /.1 AM PM BLD
I �
Location q OS C r I S 54/11`-e- , ,, ,/ ( Suite MEC
Contact Person lke{�YY t , La Ph gq-i5 / )99.9 zaq
-
Contractor (( I II ,� Ph Igeq- 8Q7.�0 s
BUILDING - Tenant/Owner t I L C L..& P�Z....- 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 • %/, AIIIPMIr , _ '. •
Roof ' ,�
Misc:
Final •
PASS PART FAIL . /...........,„/
n61•
Post & Team
Under Slab
Top Out
Sanit
Rain Drains �L firogai _il..i i - _ / ./ _ -' %' , Aar
Fi
A PART FAIL / .11� - 0 T
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, f1Rei l /G,i
Sa nitary S nspection fee of $ required before next inspeion. Pay at City Hall, 13125 SW Hall Blvd
Fire upp ]Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk qi Other Date l t3Wnspector / Ext — =
Final '
Ty PART FAIL DO NOT REMOVE this inspection record from the job site.