Permit CITY OF T P LUMBING PERMIT
/, DEVELOPMENT SERVICES PERMIT # • PLM99 -0045
'�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/18/99
-(4 PARCEL: 2S110CB -01700
SITE ADDRESS...: 11922 SW IMPERIAL AVE #314
SUBDIVISION • KING CITY APARTMENTS ZONING: ?
BLOCK • LOT • JURISDICTION: KIN
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE •MF WASHING MACH • 0 BACKFLOW PREVNTRS..: 0
OCCUPANCY GRP..:R1 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 • 1
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Replace underslab cold water piping. Installing new pipe above slab.
Owner : FEES
AMERICAN PROPERTY MANAGEMENT type amount by date recpt
1126 NE 28TH PRMT $ 25.00 B 02/18/99 KING CITY
PORTLAND OR 97232 5PCT $ 1.25 B 02/18/99 KING CITY
Phone #:
Contract or - - - - --
HYDRO TEMP MECHANICAL INC
28465 SW BOBERG RD
WILSONVILLE OR 97070
Phone #: 582 -8525 $ 26.25 TOTAL
Reg #..: 000639
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Service In
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underf 1 oor
applicable laws. All work will be done in accordance with Final I n s p e ct i o n
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 188 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-N01 -6816 through OAR 952 -6661 -6686. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Fe/14 r� } l ltY� r / c ey (A-Qd
° ' _re: Mt/ g
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + ++
JAN- 07 -'00 SAT 00:57 ID: FAX NO: #011 PO4
CITY OF TIGARD Plumbing Permit Application
"I 3125 SW HALL BLVD. Plan Checks ' .
Commercial and Residential Read By►J
TIGARD, OR 97223 Date Rec'd 2- 9 t
(503) 639 -4171 Date to P.E.
- Print or Type Date to DST •i
Incomplete or Illegible applications will not be accepted Permit
Related SWR a
Called
Name of w 7 ' i - "+. 3T.T Z?" r-
.
rD ¢8 +.,.,:' �.l , ... ..a .... ....1 &.. •�, .1��: is _ �,�� �. �: J;` �;a� • +� aK
Job Sink . �.: ,,.., w..,... �.., ........ ............. ._.;..v;. %o.�: ,..r. ,,. �, ..,. , ... , F•..k'' _a. • -:� , � , ;.= . ";.'�,•
9.00
Add Styes A - Q . S It: Lavatory 9.00 `
"' .0k. / J - / Tub or Tub/Shower Comb. 9.00 •
r ld /State 6' Shower Only 9,00
N I, a �I %: - Water Closet 9.00
. f t %1
. - /
iiii _iC 11 ' f Dishwasher 9.00
Owner M- f n, Addres +' sulfa Garbage Disposal 0,00 .
• ' •' _ Washing Machine 9.00
lath/ 0,� �: �• � Floor Drain/Floor Sink 2'
9.00
Name 3' 9.00
•
Mai ling Address 4 9.00
Occupant Suite
p Water Heater oconvetyion 0 Oka kind 9.00
Gas piping requires a separate mechanical permit.
City /State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Q i 0- -7:G /7 /It
Other Fixtures (SpeUfy) 9.00
Contractor .r • / AdG as
�/�� uite /War ' � ■mM
r;1ra L60c.�c/ 9.00
Prior to permit C' \ pate: r
I Ph • n Sewer - 1st 100' • 30.00
issuance, a Dopy , •` ' / � •
..• . s�' ! Sewer - each additional 100'
of all licenses are Oregon / Cost ont. Board Licit p, 25.00
required if (� 9/7 - Water Service - 1st 100' 30.00
expired In COT PlurnhIng Lic. `� ! L���,,,LLLL����L�� Water Service - each additional 200' 25.00
database p +++��� Pi .- 7 n 17 • Storm & Rain Drain - 1st 100' 30.00
Name Storm & Rain Drain - each additional 100' 25.00
Architect Mobile Home Space 25.00
Or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00
Pollution OevlCe
Engineer City /State Zip Phone Residential Backflow Prevention Device' 15.00
(Irrigation timing devices require a separate
Describe wont to be done: restricted enemy permit.) -
New 0 Repalr X Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.00
Residential tat Commerdal 0 Catch Basin 9.00
tional dasc of work; �� Insp. of Existing Plumbing . • 40.00
l a, C9�
y�.� perfir
��f StoA t, 1 Specially Requested Inspections 40.00
Are you capping, moving or replacing any fixtures? Rain Drain, single family dwelling 30.00
Yes 0 No 6f - Grease Trap& 9.00
If yes, see back of form to Indicate work performed by QUANTITY TOTAL e '
fixture. FAILURE TO ACCURATELY REPORT FIXTURE laor�ctric riser diagram is ..ulrea rt qua Miry Torar la > 9 `
WORK COULD RESULT IN INCREASED SEWER FE , -S.USTOTAL 7--- T
, .:W
1 nereoy acknowledge that I have read this application, that the information t i ! t �
elven is correct that I am the owner or autho ed agent of the owner, and 5% SURCHARGE
that pia miffed are In compflanca wit • ....on State Laws_ v
Sign u Own : I • : en bato
G I "PLAN REVIEW 25% OF SUBTOTAL G all
,` / ^� pQ R . ulrea on it fixture .0 . total is > 9 t, , -. _..
• -
` .4 a.----., C. � .01 1 1 TOTAL ,R
Contact Person N. " I one •.• • , , •
( r + 6tD '� 'Minimum permit fee is $25 * 5% surcharge, except Residential Backflow. . • _
:�., se I / L Prevention Device, which Is $15 + 5% surcharge ''' • "* ' ` .'
"All New commercial Buildings require plans with isometric or riser dl�9ram . • :.
and plan review :
•
- ,. � ,. ,f. At. s
. a 3 451ptumapp, doc//2./9f - , ,• }o MS•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUT • -
��oZ 3 , Requested � 3/7 AM k PM BLD _
Location _ — op �,�� �r_ / Suite y MEC
Contact Person - Ph t �� PLM 99aoV.�
Contractor _ _ �� _ �i4.•► � /L:4. - Ph SWR
BUILDING Tenant/Owner 4 37 ELC
Retaining Wall
9 ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: je
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
S
RT FAIL
c x-s K4 .
Sanitary Sewer
Rai •rain s
43= - ART FAIL
ANICAL
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 1 Ext
Other Date 2_ I .2 3 I Inspector - i
Final �-
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.