Permit CITY OF TIGARD PLUMBING PERMIT
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DEVELOPMENT SERV6CES DATE -044
PARCEL: 2S11OCB -017O0
SITE ADDRESS...: 11924 SW IMPERIAL AVE #016
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 i_Inderslab cold water piping. Installing new pipe above slab.
------ FEES - -•- - - - - --
AMERICAN PROPERTY MANAGEMENT type amount by date recpt
1126 NE 28TH PRMT $ 25.00 B 02/18/99 KING CITY
PORTLAND OR 97232 SPCT $ 1.25 B 02/18/99 KING CITY
Phone #:
Contractor
HYDRO TEMP MECHANICAL INC
28465 SW BOBERG RD
WILSONVILLE OR 97070 _._____- ---
Phone #: 582 -8525 $ 28.25 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 /Underfloor
applicable laws. All work will be done in accordance with Final I n s p e c t i o n
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)245 -1987.
Issued By: �1 ag Permittee Signature: 6 411 (C4 -O
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639-4175 by 7:00 p.m. for an inspection needed the next business day
+++- h+++++++++++++++++++++++- 1°++++++++++++++++++++ + + + + + + + + + + + + + + + + + +-h + + + + + + ++ + ++
JAN -07 - ' 00 SAT 00:56 I D: FAX NO: 1:211 P03
r
CITY OF TIGARD Plumbing Permit Application °''..
Plan Chetlt =
13125 SW HALL BLVD. Commercial and Residential Recd ey PAN
TIGARD, OR 97223 Date Rec'd - 12 -1 1 °t�(.,(�
(503) 639 -4171 Date to P.E.
- Print or Type Date to D , /
Incomplete or illegible applications will not be accepted Permit I _671
Related MR*
Called
Name of Development/Project ,� ya,•l;, �:. +':"fi'"'I�;rw — •-- •-•" -_
-. >, `'. i.t! � ��l � ..r�"'..':�M• _<iT: � F+� ;:, • : _,;: 'X=� ^.,`�!"1.
: >,,,, .1,•„� ,.,:w... 5• � , .:.:;... , .:._ „ s: , or .�;s:ti��. L � � �.:; _ ...;: •:; •�.:
Job Sink 9,00
Address $pp 1 , 4 „ n suil9 Lavatory 8.00
I 1 `� r�( Gt, ) j9 Tub or Tub /$hover Comb. 9.00 l
Bldg 1
Stata Shower Only 9.00
via Water Closet a • 9.00
�� Dishwasner 9
Owner Maii),igy Addrressa it ` ' , `1-- S e Garbage Disposal 9.00
I ` r ( Washing Machine 9,00
Zip Pho a Floor Drain/Floor Sink 2”
mits4 1723? 1 — 41 9.00
Name 3" 9.00
4" 9.00
Occupant Mailing Address Suite Water Heater O conversion 0 like kind 9.00
Gas piping requires a separate mechanical permit. _
Ctty /State Zip Phone Laundry Room Tray 9.00
Urinal 9.00
Na,. her Fixtures (Specify) 9,D0
Contractor ur SS i airs 171-11 -' '2 l -ea. Xs.
9.00
Prior to permit tats I / � � P h p on �j Sewer- 1st 100' 30.04
issuance, a Copy 1.41 9 7 Ox�. • 2,�
Sewer - each additional 100' 25,00
of all licenses are Co t ont. Board Lic Ex pate
required If /51 7 e � Water Service - 1 st 100' 30.00
expired in COT Plumbing Lic. I p t ' Water Service - each additional 200' 25.00
database 0(') - 7 T F77 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 Device
Engineer City /State Zip Phone Residential Backtlow Prevention Device' ' 15.00
(Irrigation timing devices require a separate
Describe work to b one: restricted energy permit)
New 0 Repair( Replace with like kind: Yes 0 No O Any Trap or Waste Not Connected to a Fixture ' 9,00
■
Residential Commercial 0 Catch Basin 9.00
aitionar description of work: `, 1n `& r Insp. Of Existing Plumbing 00.00
c 6( \- •a CJ x VlIW 5P'(-- Specially Requested inspections a0.0o
Rain Drain, single family dwelling 30.00
Are you capping, moving or replacing any fixtures?
Yes 0 No.)!IL Grease Traps 9,00
If yea, see back of form to Indicate work performed by
QUANTITY TOTAL t 7r :- ; ; „ iy ,:
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
isometric or riser dia is required A quantity Total Is > 9 T �• x
WORK COULD RESULT IN INCREASED SEWER. FEES. . 'SUBTOTA .
' I hereby acknowledge Nat I have read this application, that the information ` ,
's•,
given Is correct, that I am the owner or authr ed agent of the owner, and 6% SURCHARGE, .',.
E wa)
that •Ian y Di are In compliance wl z 0 - x on State Laws.' ?'
Sign. • : Owner/Agent
Date ''''PLAN REVIEW 25% OF SUBTOTAL , „:" . ;:'; ; ;; , ,,,: : ;3,
�,' R •uired on It fixture • . total Is > 9 F r_s i y i • .. :
C • arson Na . Phone TOTAL 7M' . . p ms
C 1< `C` TK—Q,r)S - Minimum permit fee is $25 + 5:h surcharge except Residential Baddiow
Ck 11 r Prevention Device, whirrs is $15.6% surcharge ' " '
"Ail New Commercial Building, require plans with isometric or riser diagram '
and plan review
✓Ja19�plumapp.Qac M/99 .. • ...:'y °•r' � ?''{ •
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
io6) Date Requested c)/,a,3`l�' AM PM BLD Mir
Location //9, V � Suite /'D MEC
Contact Person ��Ta�v>t� P � 5 PLM 7
Contractor ' �� n .2e n Ph SWR
BUILDING Tenant/Owner ( // it 4&) ELC
Retaining Wall Q ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab O . SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F P
inl ac T FAIL Clc 5 (... 4' L
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
'� PART FAIL
4 .�-!N`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
Other Date 210 \9 Inspector Ext
Final
- PASS PART FAIL DO NOT REMOVE this inspection record from the job site.