Permit CITY TIGARD PLUMBING PERMIT
) 1/4. 4 ' "" p�'ll DEVELOPMENT SERVICES PERMIT #: PLM2000 -00325
^ `--- r "" 13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171
DATE ISSUED: 8/31/00
SITE ADDRESS: 08200 SW HUNZIKER ST PARCEL: 2S10100 -00700
SUBDIVISION: FOUNDRY INDUSTRIAL PARK ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: B FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: 2 URINALS: 1 GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 2 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing work associated with commercial TI. Relocating 2 water closets, 1 urinal, 2 lays, 1 sink and 1 water
heater. Adding 1 2" floor drain and 1 lay. Capping 1 sink.
FEES
Owner:
Type By Date Amount Receipt
NORTHWEST DEMOLITION PRMT CTR 8/31/00 $103.50 27200000000
PO BOX 930 5PCT CTR 8/31/00 $8.28 27200000000
WILSONVILLE, OR 97070
Total $111.78
Phone 1: 503 - 638 -6900
Contractor:
DEAN WARREN PLUMBING
3111 SE 13TH
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone 1: 236 -4152 Top -out Insp
Reg #: LIC 172 Final Inspection
PLM 26 -83PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
,
CITY OF TIGARD Plumbing Permit Application • Pla heck#
13125 SW HALL BLVD. Commercial and Residential Re 'd By . '
TIGARD, OR 97223 Date ec'd i' -fi0
(503 639 -4171 Date to P.E.
Print or Type Date to D
Incomplete or illegible applications will not be accepted Permit # t ®oQ3gS
Related SWR #
Called
Name of Development/Project FIXTURES %'(individual) '" It - "q=?> ;TW , QTY;<'= ;PRICE" AMT
Job hi ki Ini VAA.e2LtTivev Sink : ...,.,. 11.50 l.b
Address Street Address 1 � - Suite Lavatory 11.50 l
• K �IOO Suo�tAn/1 Tub or Tub /Shower Comb. 11.50
Bldg # City /State Zip
- i / A q � Shower Only 11.50
Name C7 " Water Closet , 11.50 95 ,G
?J t'- 1') ® D p f i btu Urinal f . 11.50 / . 5
Owner i/iailing Address t Suite Dishwasher 11.50
rs't "ems '; b$� !Alt IV €Y�. Garbage Disposal 11.50
City /State Zip _ Phone
1 ,, &X- 9cc:, Laundry Tray 11.50
. Name . ;, Washing Machine /Laundry Tray 11.50
LA- 0 L Q L \, \ \ p ..) Floor Drain /Floor Sink 2" 1 11.50 f f' 60
Occupant Mailing Address a Suite 3 F 11.50
8 ACC Std um 21 KIEV 4^ 11.50
City /State Zip Phone
°T1 6,.m 6,3g°GctOd Water Heater 0 conversion 0 like kind ' 11.50 // S-6
Name Gas piping requires a separate mechanical permit.
.1". AiV tA ) A-nkGi (BIZ 6-- MEG . Home New Water Service 32.00
Contractor Mailing Address Suite `7• MFG Home New San /Storm Sewer 32.00 •
311% S t. /3 Hose Bibs 11.50
Prior to permit ity /State ip Phone Roof Drains 11.50
issuance, a copy p ,.,, 9 aZ b 4 \5a
Drinking Fountain 11.50
`all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if ® ) 7 Ja ( 1 a3) ou Other Fixtures (Specify) 15.00
expired in COT Plumbing Lic. # Exp. Date `
database 1!e) 83 P 8 6/ 1
Name r f
Architect Sewer - 1st 100' 38.00
or • Mailing Address Suite Sewer - each additional 100' 32.00
En ineer City /State Zip Phone Water Service - 1st 100' 38.00
g Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New X Repair 0 Replace with like kind: YesK No 0
Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial
Additional description of work: ReLookr , x,,s -^,...4' Commercial Back Flow Prevention Device 32.00
a - we• J i- LAPr e a -t-A• t r, /-5,A4.). / 4Iw 1 4 Residential Backflow Prevention Device* 19.00
41)e) / - Fe) * / ,L„Ali Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of, Existing Plumbing or Specially Requested 50.00
Yes No 0 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 :;:,t;;.;;;;;-;
I
hereby acknowledge that I have read this application, that the information . 4; ,
given is correct, that I am the owner or authorized agent of the owner, and Isometric or riser diagram is required if Quantit Total is > 9
that. plans submitted are in compliance liance with Oregon State Laws. *SUBTOTAL 7 ,7 , : 22. 5-0 Sigfa - hire afOwner /Ag�.nt Date, ,., , : , ` ~ ' 1 ' "' l�J
_/ �� g ry cr/ 8% SURCHARGE "" 'W;;; . ag/
Co t Person Name Phone ti . r_ - ' a "
S N / E L_Lp c S Q3(0 5-a * *PLAN REVIEW 25% OF SUBTOTAL , ;;';7?
,� • y �. = r Required only if fiixture.gty. total is > 9 ` 4
: ; BATH =HOU 178 994 ' ate 1
.��.>
iBA` TOTAL
THHOUSE 250'00 ~:
re'k.: 'T .
S
raATH;HOUSE.S5
� 28:00- 1! - d Gl � ■ yV
'' .' 4 � : ::: ° -, "' °sus. 'i "'" '%;,
`t ti'; - .
' ii'' , ` .r y, i
J4a4r,1 ing =filct3- 19"the: , 1,-II n g,Bn dth , 6; fir S : : , " -Minimum ermitfee is$50 +8/ surchar a except f , e et of s anitary ,E tort w c )1 _tt k Device, whi is $25 + 8 / surcharge g tResidential Backflow Prevention
p
* *All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
.1: 1dsts1forms1plumapp.doc 11/18/99
•
•
PLEASE COMPLETE:
• , Fixture Type . Quantity Work Pjfoned.
M"rvio-via," p'00-pritay 5R0,0.00,046076:4„
Sink I
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 J.
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
.1)Zke s/A/re —
-
•
.1: dsts forms plumapp. doc 11/18/99
•
I �-
m Accumulative Sewer Tally
Tenan?. Name: " c ' " ' ' �l This SWR# 7
Addresj;: ;Aid!" • o'� 4IF . , This PLM #: P - - 3 P.5"
Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New
# Value Capped off value added # added #s total
Count off #s count value values
Baptistry/Font 4
Bath - Tub /Shower 4
- Jacuzzi/Whirlpool 4 •
Car Wash - Each Stall 6 ,
- Drive Through 16
Cuspidor/Water Aspirator 1 ,
Dishwasher - Commercial 4
- Domestic 2 - ,
Drinking Fountain 1 ,
Eye Wash . 1 1
Floor Drain/sink - 2 inch 2 r
- 3 inch 5
- 4 inch 6
- Car Wash Drn 6 ,
•
Garbage - Disposal 16
- Domestic (to 3/4 HP) •
- Commercial (to 5 HP) 32 ■
- Industrial (over 5 HP) 48 - -
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6 V
Rec. Vehicle Dump Station 16 _
Shower - Gang (Per Head) 1
- Stall 2 , Y r ,
Sink - Bar /Lavatory 2 F
Bradley 5 .
- Commercial - 3 ( 3
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6 •
Water Extractor 6 .
Water Closet - Toilet 6
Urinal • 6 ,
TOTALS
/ 3 f . / i
J // � J
Total fixture values: divided by 16 =
/ 0 6 EDU l 6'C .4/10 ,
HISTORY
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# ' • EDU# SWR# PLM# EDU# SWR#
i :\dstskswrtaly.doc
•
CITY OF TIGARD BUILDING INSPECTION DIVISION •
MST •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP rid
{ Date Requested -' AM PM BLD (r.
Location 'Zee v ) A) #' rZ » � C --- Suite MEC
Contact Person Ph X 36 ° / s PLM vu — ( ' 4. , Z
Contractor Ph SWR
BUILDING �':���;z Tenant/Owner ELC
Retaining Wall ELR
Footing Access: ;2- �[
Foundation �a 4.4 �f , FPS
Ftg Drain 7 (/ SGN
Crawl Drain Inspection Notes:�,� /7a
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing .
Firewall
Fire Sprinkler
Fire. Alarm ekS ✓/Y 4
Susp'd Ceiling . "7
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rai! I rains
• RT FAIL
ANICALa,s ; '3s
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
$ITE ° ....
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: V [ ] Unable to inspect - no access
ADA •
Approach /Sidewalk Other Date 3,J' </O Inspector Ext
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site. •