Permit A , CITY OF TIGARD PLUMBING PERMIT
1;� DEVELOPMENT SERVICES PERMIT #: PLM1999 -00332
44- je 13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/14/1999
SITE ADDRESS: 07805 SW HUNZIKER ST PARCEL: 2S101 BD -00103
SUBDIVISION: ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: 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: 100 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of a new commercial back flow prevention device and water line.
FEES
Owner:
Type By Date Amount Receipt
NORRIS BEGGS SIMPSON PROPERTY PRMT KJP 10/14/199 $70.00 99- 319087
10260 SW GREENBURG 5PCT KJP 10/14/199 $5.60 99- 319087
TIGARD, OR 97223
Total $75.60
Phone 1:
Contractor:
M P PLUMBING CO (MILWAUKIE)
P 0 BOX 393
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone Water Service Insp
hone 1: 655 -9161
Reg #: L IC 000050 RP /Backflow Preventer
g Final Inspection
PLM 3 -17PB
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Ann . ,_ Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
CITYOFJIQARD Plumbing Permit Application Plan Chedc Si
13125 SW.i. °,; Commercial and Residential Recd By
TI ^�`�' '� 7 �
oil I ' 1., „'.• �� � RECEIVED �EC�� . . Date Recd
• (503) 139 .' e £ - • ; Date to P.E.
_� # N, Print or Type OCT � Date to DST
t j or Illegible appli4ations will not be acc e `d
7. Perrrmits Gl!!�!rr4 -ao3
1 < t i, r » ,,. r~' , ` EQM i �e. r Related SWR *
.� `e - ;ta 1 :', tE '104 3 `'�
' `� '' (r, X t '•�'' +aa '� t f 's pa � X �' _
; !!. ' , . . tt a.vk Y s. P,n!.it4.suukr' , &aft`" 9 „ '. ? fe!?a e"y, = � ' F ? ,1 r t^ r. ,, . 0 r a M t p + . •, ' t ° -" , __ .. _ .,
!` iiw3 �'!k'" dt r f " �'i+,� -,�, a"..•_ww,pee¢1�Gy aK R
{ ,f" F t , r' �7w� f ,r! �S � 9 t , s1. 7".:':' � i 1 f II ■ 9 d
J - '-':4'11.i , .. d l .:, ` : ,.. ,�" '- r' s to s ,- .r ; 'i ,, - .r
A � v , w , S r , ^ L ivat ry ., ..: t l •. , :..11 -
i t � mF�.i� � � ' • i - a ; ��� .w. t ... ' r .0 P•-,s , .rte �c ,+ } t 1 � . .. . .
•' ..,, i - TuborTublSh Comb i- 11.50
.''
S hower On�f 1t S " 11.50
t; y Water Closetllktnal p fYl R ` 11.50
z : r2;. j: r 4/�' 7i. b ,'�. 11.50
Y o w n er y ` !ress , ; _ ' e ; G l e ' , , 3 ` b k , _ 1 1. 5 0
. rttX ' W y I< i t v -ti,z ,- .4 -c., t f 41t
r }. $y) 11:50.
„-L .t. .r 'j'': &.) v 1. .�. -�', - .' Orti Sink : ., : r ryy s X44 " 11.5
e j a sk - 4 -` $ '..4 ` ; ,11.50
� 4-,.',,,,1" d - ' "� , 11.50 •
occu Address
pant Suite Water Heater 0 conversion (! tend 11.50
. Gas piping requires a separate mechlirit i permit. '
- - - City/State : • Zip Phone MFG Home New Water Service 28.00
Name MFG Home New San/Storm Sewer _ 28.00
_ . rAP. - V I Lvsytiot W Hose Bibs 11.50
a c t Suite
Contr Rain Drains 11.50
• or 3 Drinking Fountain 11.50
Prior to permit bneeiitel Other Fixtures (Specify) 15.00
of all licenses are Oregon Car1S1~ cg0rd Lic.# Ex U .
required if L -
expired in COT Plumbing Lic -
.. ( L " Ex . t��
database f l �/ l Y � U
Name Sewer -1st 100' 38.00
Architect -, - - . Sewer - each additional 100 32.00
sr ¢ AAang Alddress Suite Water.Service -1st 100' .' / 38.00 � '?-2 Engineer . .- Cdy 4 _ . Zip Phone
Water Service - each additional 200' f 32.00
Storm & Rain Drain - 1st 100' 38.00
Deccibe work to ba. done:- -•-• : - Storm & Rain Drain - each additional 100' 32.00
New 0 Repair 0 Repla with like kind: Yes 6 No 0 Commercial Back Flow Prevention Device / 32.00
Residential 0 • Commercial Residential Beddow 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 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
y PP QUANTITY TOTAL
given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required 5 Quantity Total is > 9 '' i
that plans submitted are in compliance with Oregon State Laws. `SUBTOTAL �
Signature of Owner/Agent at L
SURCHARGE ::'
�% , j(pt;
91"
r , x . ! ;f' :', _ ' - :x .,, ,7 s ° "5 W I ** PLAN REVIEW 25% OF SUBTOTAL w c
• Required only if fixture qty. total is >9 ' -'. ' „,, „;;;;, «
,TOTAL , I 9 -
. . . . .E.+x
t
isni iWm p�e far I4 $50 + 7% surcharge, eitieilt Residential Backflow Prevention
Pilings t4dkAi ,. 5 +716surehar f
a _ ' 1, r t «$d it +t y c , i 'gyp i r T� y BitAdings require pieps, isometric or riser diagram and
4 4' ,, a $ 'i'6 s s h N r',�' i t ' '''P' .1'-i'; t -!! ai ? • rt f t
r i �? d a t t s F p , �n,' FF * . k m " � • $ r } s � ` � � e.. � 3�i � R �; �` i ¢ t t� � a � .ft � 4 i �,� � 7 v _ k� r , Otto-, h. P
- ,
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PLEASE-COMPLETE:
. .
gf
r 4 7 (=I tAl .0 r :
= • ' '
.11 ; 1
, < . . •
- • * • •
Lat* T •
Lib/Shower Combination
•
•
S oeQnIy
Vlialeir Set
•
Dts her ,-,.„••
•
ti
f3 IS osal
WaSlitn,9.Machine
Flatifprain/Floor Sink 2"
4 "
Water Heater
Lautidn,t Room Tray
. .
Urinal
Other Fixtures (Specify)
•
COMMENTS REGARDING ABOVE:
-
, .
ti 54
•
thvot t • `1C1 '-`
4
- ; v, 4104 4.111.,;*41i.'401?'W41*;04,010* 4, ' ,
, 7 '"1 t') .1" • t , ek,411
r ■ I 4 A 4 ,4 ,,,y , t• , i4 , 4 :
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 10 I ( q AM PM BLD
Location 7 �U 64A/t at;b Suite MEC
Contact Person )( P o,(,(/yK- Ph 19f(, ( PLM / g / 1 - CO 3 3d-
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
P RT FAIL
C, UMBIN
Posfh es am
Under ab
Top Out
Water Se
Sanitary Sewer
R rains
anal
,)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
Date
Other 4)/ ( i ( ?) Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.