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Permit CITY TIGARD PLUMBING PERMIT 1 % DEVELOPMENT SERVICES PERMIT #: PLM2004 -00050 e �fli DATE ISSUED: 2/6/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 10215 SW HALL BLVD PARCEL: 1S135AA -01400 SUBDIVISION: METZGER ACRE TRACTS ZONING: C -N BLOCK: LOT: 037 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: B FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: 3 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: 1 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Fixtures for TI. FEES Owner: Description Date Amount S 10215 HALL HALL BLVD [PLUMB] Permit Fee 2/5/04 $72.50 10215 TIGARD, OR 97223 [TAX] 8% State Surcharl 2/5/04 $5.80 Total $78.30 Phone : 503 245 - 2415 Contractor: BEAVERTON PLUMBING INC 13980 SW TUALATIN VALLEY HWY BEAVERTON, OR 97005 REQUIRED INSPECTIONS Phone : 643 7619 Rough -in Insp Top -out Insp Reg #: LIC 12889 Final Inspection PLM 34 -4PB 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 Is ued By : /7, +/ ' Permittee Signature: X �L�//7 Call (503 • 9 -4175 by 7:00 P.M. for an inspection needed the next business d ' liuiiaing r ixt ures PlumFbing Permit Appli eY i i% , G 'Jl FOR OFFICE USE ONLY !" t " ` ' ` IVED Received i Plumbing Date/By:p?'Gj !' Permit No.� ��� DDJSO City of Tigard [p , Planning Approval Sewer FEB 5 100 Date /By: Permit No.: 4Q ,0. 9'-r. ©0041,., 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 CI OF TI - DataBy: Permit No.: Phone: 503- 639 -4171 Fax 503 -598 -1960 Post - Review Land Use BUI 4n t ' ri A l . .i I''` . ?ON Date/By: Case No.: Internet: www.ci.tigard.or.us --,, ii , I Cont Juris.: 24 -hour Inspection Request: 503- 639 -4175 ` ° Su See Page for p q Name /Method: 77c.‘„ Supplemental Lnformation. ..;, �c4 .iC,;r;:,�f�`; {.r�:'XB S,. � ,_. ".aK�'5.1:)F,., k :, t5 " S , , +:a � � _ F.,:g, .- •.���.w. �',PEOIiWORI{:�,s3 s. ' ;��. � � ��_ �,tS�.: ;,.;.. , ,.. 3 �., , ,., �r� ..r.,_.:.,,e _- ...: >, :� ��' `�FEE.�;S,CHED,UtiE,(fo information use`checklist),�,�,�.� ❑ New construction ❑ Demolition Description I Qty. I Fee(ea) I Total ® Addition/alteration/replacement 1, b , ; .` l z;iVew 1 4 2'fatntl°Rdwellln s ' x Et > ' t h e d��:. •I e;. ^ Y'" 7k - - p ❑ Other: '�W:,i if „�m����. icy' ��'�. �:, t? � �§ �'z JtR _.� b.bil+rrF Y 4. fiy6d� �,:; ri;c.:: si . -tom. r 4 e :r : ,: ,.::s ,: F i';,:;;,,_ ; ;'ias ,..,,a_. tucludesil00tft. dii,::eich utili connection ` ` *' � ,' "; : IORCAT.E0,01 + C ONSTOVOTIO1 - . ( ? , ,<.' 1 & 2-Family dwelling SFR (1) bath 249.20 El y g ® Commercial /Industrial SFR (2) bath • 350.00 ❑Accessory Building ❑ Multi- Family SFR (3) bath 399.00 El Master Builder ❑ Other: Each additional bath/kitchen 45.00 4g.; M4 , ; Bx IT0INF, 1 t 140 Fire sprinkler - sq. ft.: Page 2 Job site address: • - - - s =, r<:%:;� ;. ,, .., , ,. s . s : _. ,x.,> :.;, T ,.. ; �44H, ;. � . ,r ,, Jry ;��". /d� � � • �Ma., h d �� � � x_,� � .�� �:�� tte Uti�tti_es� ~ .;�,. ,� .� ri � "� � �� ,� Suite #: I Bldg. /Apt. #: Catch basin /area drain 16.60 Project Name: N' ECi 0 WI PJl9 Drool Uleach line/trench drain 16.60 I Footing drain (no. linear ft.) Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 /,&:„.2 /S S. 12) , HALL- Manholes 16.60 Rain drain connector 16.60 • Sanitary sewer (no. linear ft.) • Page 2 Subdivision: Lot #: Storm sewer (no. linear ft.) - Page 2 Tax map /parcel #: Water service (no. linear ft.) Page 2 ,^°a -FX.:" .�:., ....., .- R_ �� ":, s� �A"aP "' u� . •.k" :7 r "' ^:'na,"� >o�t `'�iF:riS?+���' ^;F � � i '' "•' - �,r•, :.4 i F'ixtu`re or, <Item K M. .t .. t s= e>. �� .�r7..::.:��:,DESCIt1PTION'.OF WQRKa,•�:_�„•,:.,;�; �¢� �,��.r, �,..,. � , : �, � - � ��.,u.�.: �.�..w,....�^�;4i�t: ', k ` ° " =`u' _ "* :' "_" Absorption valve 16.60 ADD'Tied, Oi-- 2- / JAiJCS Backflow preventer Page 2 1 N $7 -L(. h L q LAi /, Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 <' I2TFY OWNER ,, ,k -k Drinking fountain 16.60 PROPE eti �sl TENANT:,gs±a;.%� 1 - ' Ejectors /sump 16.60 Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City /State /Zip: Floor drain/floor sink/hub 16.60 . Garbage disposal 16.60 Phone: Fax: Hose bib 16.60 ii 'i "' OlftICAN7'e.' "=t ' ` i t,`k ' N Kel reOP1TAG:T,VPERSONMO Ice maker 16.60 Name: Interceptor /grease trap \ 16.60 Address: Medical gas - value: $ _P ge 2 City /State /Zip: Primer 16.60 Roof drain ial) 16.60 Phone: I Fax: Sink/b" tn/lavatory ' : 16.60 l.19 E -mail: Tub /sh ower pan 16.60 ",ti k " s' 1'h..:: OONTRROTO1 ` 'g °°;" is Urinal 16.60 Business Name: ���� �(' � � /PC W ater closet r• . / 1 16.60 � � , �I StJ ,�- v. `r Water heater _ 16.60 3 Address: j Other: City /State /Zip: ` L, O', 'J 7c)O5' Other: � ` (( Phone: 6 yy wt /9-J ': �, ; . *' :;Vs'iR y - :i � lj I - Y .;,,z* # N g q Fax: `a � .:�� c,,z.. .� 1 mtiliig. Per., mil ,Fees,r,�r:�����• < �4pa Subtotal $ CCB Lic. #: / Plumb. Lic. #: f y Minimum Permit Fee $72.50 $ �� `l Authorized - J ' V C / ' V C / o / Residential Backflow Minimum Fee $36.25 Si nature: Date: L Plan Review (25% of Permit Fee) $ Otfd I,JOt) (1. State Surcharge (8% of Permit Fee) $ 5. k(�- f (Please print name) TOTAL PERMIT FEE $ 73, So Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri- County Building Industry Service Board. , i:\Dsts\Permit FormsV'ImPermitApp.doc 01 /03 • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received 4/. Date Requeste 4 7-2 Z �� PM BUP Location /D 2.1 S i�F �(.�� ` Suite MEC Contact Person Ph ( ) ( ‘573 Contractor \ LPA' 4 • Ph ( G C43- ?mil? SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab W 5 t-In ater ervice Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain - Shower Pan Other: Fi S PART FAIL ECHANICAL Post, & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRIC AL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required . before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA D Inspector Ext Approach/Sidewalk P Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL