Permit A CITY OF TIGARD
� DEVELOPMENT SERVICES PLUMBING PERMIT
0 4m 6 Il PERMIT #..... ° .: PLM97 -041 5
' .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1 114 / 97
�\ \� PARCEL: 2S101BC -00101
SITE ADDRESS...: 08 5 SW HUNZIKER ST #C
SUBDIVISION ZONING: I —L
BLOCK.L........ LOT ° JURISDICTION: TIG
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE -COM WASHING MACH - 0 BACKFLOW PREVNTRS.°,: 0
OCCUPANCY GRP.. :B FLOOR DRAINS......: 0 TRAPS ° 0
STORIES ° 0 WATER HEATERS 0 CATCH BASINS - 0
FIXTURES LAUNDRY TRAYS : 0 SF RAIN DRAINS • 0
SINKS 0 URINALS - 0 GREASE TRAPS - 0
LAVATORIES....: 0 OTHER FIXTURES....: 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS ° 0 RAIN DRAIN (ft)...: 100
Remarks: KNEZ
Owner: -- FEES - - --
KNEZ REALTY GROUP type amount by date recpt
8185 SW HUNZIKER RD PRMT $ 30.00 JSD 10/14/97 97- 300039
TIGARD OR 97223 5PCT $ 1.50 JSD 10/14/97 97- 300039
Phone #:
Contractor
CENTREX CONSTRUCTION INC
8250 SW HUNZIKER RD
TIGARD OR 97223
Phone #: 684 -0443 $ 31.50 TOTAL
Reg #..: 000563
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Storm Drain Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspect Inspection
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- fA10 through OAR 952 - " 1 -0080: You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Ar
401:40
Issued By Permittee Signature: • _
++++++++++++++++++ +,4-++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
++++++++++++++++++++++++++++++++++++++- I-++++++++ + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + ++
•
CITY OF TIGARD Plumbing Application Rec'd By , CP,
13125 SW,J -.TALL BLVD. Commercial and Residential Date Recd /Ul y
TIGARD, OR 97223 Date to P.E.
Date to DST
(503) 639 -4171 Permit* r /�� 7 -0 5
Print or Type Related SWR it
Incomplete or illegible applications will not be accepted Called /7- 0
(/
Name of Development/Project On back indicate Work Performed by fixture.
Job .fte5' 1 )• - Z i; G li )AT 1 A Ls. FIXTURES (Indivlduail=. = .,3: `' `<','= ' .QT„fi PWCE ..)WT, e,
Address Street Address Suite Sink 9.00
Ce (BS 5(-) k k>v Z k. Lavatory 9.00
Bldg # I City /State Zip Tub or Tub /Shower Comb. 9.00
Name tq / Shower Only 9.00
=p&U )IQ ._..'L SR_ Water Closet 9.00
Owner Mailing Address Suite Dishwasher 9.00
%'s 5LJ (Apsivt, i; UtL Garbage Disposal 9.00
City/State Zip Phone
- Washing Machine 9.00
rtGPR,D 06Z, 97 6. d -c &(�
Name ) Floor Drain 2" 9.00
3" 9.00
Occupant Mailing Address Suite 4' 9.00
City /State Zip Phone Water Heater 0 conversion 0 like kind 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
^
c.t t 0 ‘ACl . 1 Other Fixtures (Specify) 9.00
Contractor Mailing Address ,
?O tn) UfJ2.1 Ke
9.00
Prior to permit City/State Zi Phone ` 9.00
issuance, a copy T2c, A u � 2 Cg 4 -04 , 9.00
of all licenses are Oregon Coset. front. Board Lic.# p. at '(,;( 9.00
required if e., S g � Q ��/� Sewer -1st 100" 30.00
expired in COT Plumbing Lic. # Exji� Date
database Sewer -each additional 100' 25.00
Name /' Water Service - 1st 100' 30.00
Architect P,tj p `c\ J.\r' * Pkot( T Water Service - each additional 200' 25.00
or Mailing Address Suite Storm & Rain Drain - 1st 100' / t 30.00
.a=ta 3 s„,.iT Storm & Rain Drain - each additional 100' 25.00
Engineer City/State r � Zip Phone Mobile Home Space 25.00
l-
'A t UK _ tt1 R' c-t. Commercial Back Flow Prevention Device or Anti- 25.00
Describe work New 0 Addition 0 Alteration48 Repair 0 Pollution Device
to be done: Residential 0 Non - residential Residential Backflow Prevention Device* 15.00
Additional description of work:
51aQtM "E��� 9�Q f F/ Any Trap or Waste Not Connected to a Fixture 9.00
fey1) ""ip Catch Basin 9.00
F*410 tic) SW T14 ft`l CLw Insp. of Existing Plumbing 40.00
per/hr
Existing use of • Specially Requested Inspections 40.00
building or property - per /hr
Rain Drain, single family dwelling 30.00
Proposed use of Grease Traps 9.00
building or property
QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information _ Isometric or riser diagram is required if Quanity Total is > 9
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL
that plans submitted are i ; :,:.- ce with Oregon State Laws.
.
nature of Own =� Date 5% SURCHARGE ,, ri- ; )
('
. ,, � i -t y 9 m J `/
Contact -arson Name Phone PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total is > 9
TOTAL 116' L
'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow
Prevention Device, which is $15 + 5% surcharge
I:'dstslplmapp.doc 5/97
PLEASE COMPLETE:
Performed
Capp "rRenioVed.::: .
Sink
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
3 „
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
•
•
COMMENTS REGARDING ABOVE:
I: NdstsIplmapp doc 5/97
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
D) ante Requested 1 AM PM BLD
Location 11S ,� 4 Suite MEC
Contact Person Ph PLM � — - Lc .
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
/ •
/ FPS
Ftg Drain Z ( ` C/O
Crawl Drain Inspection Notes: I' SGN
Slab — IT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation /
Drywall Nailing _ Afir
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
P A R \ T FAIL
Under Slab
Top Out
Water Service
Sanita Sewer
- in Dr.' • •
:_, PART FAIL 1
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICALy R
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 l
Other Date v 9 Inspector Ext
Final
PASS PART FAIL DO NOT REMO E this inspection record from the job site.