Permit CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
4 ∎ ''�-� 1 13125 SW Hall Blvd., Tigard, OR 97223 503 DATE 639 -4171 MIT S #. D : 0 : � :44 / 977— 94
DATE ...,SUED: 7//97
PARCEL: 2S 1 O 1 BC -00200
SITE ADDRESS...: 08205 SW HUNZIKER ST
SUBDIVISION....: ZONING: I —L
BLOCK........... 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 2 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....: 1 RAIN DRAIN (ft)...: 0
Remarks: Tenant improvement of first and second floors
Owner: FEES -----
KNEZ REALTY GROUP type - .amount by date recpt
8185 SW HUNZIKER PRMT $ 27.00 B 07/24/97 972 -97524
TIGARD OR 97223 5PCT $ 1.35 B 07/24/97 972- 97524
Phone #:
Contract or
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD OR 97223 -- --
Phone #: 503- 639 -5296 $ 28.35 TOTAL
Reg it..: 000024
-- - - - - -- REQUIRED INSPECTIONS
This perait is issued subject to the regulations contained in the Top —out Insp -•••_
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final 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-m01-0010 through OAR 952- 0001 -0080. You may
obtain copies of these rules or direct questions to DUNG by calling
(503)246 -1987:
Issued B y. Ailt-ag-ftAr P e r m i t t e e Signature : .. : ,, .,,,o ' '/
1- 1-++++++++++++++++++- F•+++++++++++++++++++++ ++ + + + + + ++ + + + + + + + + + + + + + + + + + + + + +1, + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + ++ + + + + + + + + + + + + + ++
Y OF TIGARD Plumbing Application Recd By =�
3 25 SW HALL BLVD. • Commercial and Residential Date Recd 07 I
_BARD, OR 97223 Date to P.E.
Date to DST
3) 639 -4171.
Permit* f _K 17 - ii
Print or Type Related SWR * 97 - bZ4
Incomplete or illegible applications will not be accepted. Called 1 - z -f -7
•
Name of Development/Project -f.P. �IJRES,.(bldlvldU&)' � Q .gip 461.4111
�
Job h'dc)Gr9 17izds Sink _ 2. 9.00 /X
Lavatory 9.00
S treet Address Suite
Address Tub or Tub/Shower Comb.
Bldg s City/State Zip Shower Only 9.00
_ CI - Water Closet 900
Name
e Z I?o l �7 Rio - po,� / 9.00_ ,q'
Owner egress
8/ SLi/ / 4.4.);2 4/ Washing Machine 9.00
City/State Zip Phone -- Floor Drain - 2' 9.00
' 41 vie 472/2,3 4 - (p /4,P 3• 9.00
Pte✓ easai 4 9.00
Occupant ding Address ties Suite Water Heater 9.00
f 1 101 0 S ti/ 7,L - Laundry Room Tray 9.00
•
City/State Zip Phone Urinal
T ,.cf O)2 ri Z )21" ( -123 Other Fodures (Specify) -
NW a 9.00
4..3 !g•t/ P/CG1,v4114. 9.00
Contractor I quite - 9.00
d Gf/ ��.P✓ti 9.00
•
(Prior to issuance /State •
applicant must ik a zip r j C 72,z3 6,3 - .F6 9.00
provide a0 O on Co Cont. Board Lie.* Exp. Date 9.00
contractors 02E13 S (0.-14,- F2 9.00
license Plumbing Lk. s Exp. Date Sewer - 1st 100- 30.00
information 3 C( - a.4' P (4 fY - • Sewer - each additional 100' 25.00
for COT COT Business Tax or Metros Exp. Date
Water - 1st 100•
database). 0.2 q 3q / -`- cg ar 30.00
Name 0 Water Service - each additional t 25.00
Architect A)_/4 Storm & Rain Drain - 1st 100• • 30.00
or +9 Add Suite Storm & Rain Drain -sect additional 100' 25.00
Mobile Home Space 25.00
Engineer City /State Zip Phone Commercial Back Flow Prevention Device or Anti. 25.00
_ -- • Pollution Device '• ' _
.Describe work New 0 Addition 0 Alteration 0 Repair 0 Residential Baddlow Prevention Device' 15.00
n be done: Residential 0 Non - residential 0 Any Trap or Waste Not Connected to a Fixture 9.00
.dditionai desaiptiort of worst _ Catch Basin 9.00
•
• - - . - -. Insp. of Existing Plumbing - 40.00
per/hr
,sting use of Specially Requested Inspections 40.00
per/hr
:0 r du g or property Rain Drain, single family dwelling 30.00
- ''posed use of . - - ,_ . Grease Traps .. . 9.00
-A.-aiding or property
- . QUANTITY TOTAL =<< •;;« ;;
• you capping , moving or replacing any fixtures? Yes (� No p Isometric or riser � :walked Q is rirod Duana m > y To is 9 4 :. ; ,..�:•:: .;•: , :: .
? yes see back of form) 'SUBTOTAL /!
ereby acknowledge that I have read this application, that the information S-.O r
'. sn is correct that I am the owner or authorized agent of the owner, and 5% SURCHARGE
at plans submitted are in compliance with Oregon State Laws. . ; -
T ina r/Age��r Date PLAN REVIEW 25% OF SUBTOTAL
/4i* Reeu�ed any i/ ftNNre cry. total is > 9 ` �,
�9h e/ �7 TOTAL � -°172z1, -°172z1, :
., -.- ,,
.: »ntact Person me on
*Minimum permit fee is 525 + 5% surcharge. except Residential Baalkfl •
Prevention Device• which is 515 + 5% surcharge 2j.b5 1 -CD
I: \pimapp.doc 12196. (dst)
'LEASE COMPLETE AS APPROPRIATE TO PROJECT:
I Fixtures to be capped, moved or replaced .Qty
Sink
Lavatory
Tub or Tub /Shower Combination -
Shower Only -
Water Closet _
Dishwasher
Garbage Disposal •
Washing Machine
Floor Drain - - 2"
. .
-- 4" - •
Water Heater •
Laundry Room Tray
Urinal /
Other Fixtures (Specify)
•
3OMMENTS REGARDING ABOVE: _ _
Q - i-4 I-' i/.t' 1 u Fr Mme► �� cA.1 Ada -0 .
1:\plrnapp.doc 12/96 (dst)
7/18/99 Activities for Case #: PLM97 -00294
6:08:39 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 Application received 7/18/97 JD RECD BON 7/24/97
PLMC005 Permit Created 7/24/97 B PASS BON 7/24/97
PLMC799 Final Inspection 9/8/97 MS PASS J *H 9/11/97
PLMC725 Top -out lnsp 7/24/97 8/4/97 MS PASS MRS 8/5/97
PLMC015 DST Post Review Complete 7/24/97 B PASS BON 7/24/97
PLMC040 (F) Ready to issue 7/24/97 B MEMO BON 7/24/97 Must pay SWR97 -0285 before
issuing this permit. Also, need
current CCB and plumbing
license.
PLMCO50 (F) Issue permit 7/24/97 B PASS BON 7/24/97
PLMC720 PLM/Underfloor 7/31/97 MS FAIL J*H 8/25/97 NO TEST
PLMC800 Case Finaled 9/11/97 MS PASS J *H 9/11/97
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