Permit •
CITY OF TIGARD
i�,nfro DEVELOPMENT SERVICES PLUMBING PERMIT
s •j �J'I PERMIT #.. ... ° : PLM99-0038
jA - 13125 SW Hall Blvd., Tigard, OR 97223.(503) 639 -4171 DATE ISSUED: 02/18/99
PARCEL.: 2S 110CA -00200
SITE ADDRESS...: 11975 SW KING GEORGE DR #011
SUBDIVISION....: ZONING:
BLOCK LOT JURISDICTION: KIN
CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 .MOBILE HOME SPACES.: 0
TYPE OF USE....:MF WASHING MACH 0 BACKFLOW PREV.NTRS..: 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: Replacing underslab coldwater 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 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 $ 26.25 TOTAL
Reg #..: 000639
REQUIRED I NSPECT IONS
This permit is issued subject to the regulations contained in the Water Service I n
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM /Underfloor
applicable laws. All work will be done in accordance with Final Inspection
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 ',1 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
�C
Issued By: F'ermittee Signature: ifllcotAv
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business, day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
'JAN-07 -'00 SAT 00:43 ID: FAX NO: #009 P03
CITY OF TIGARD Plumbing Permit A' -
°'1' :`
%
13125 8W BLVD. 9 Application Plan .
HALL B Commercial and Residential CNN.", '' ''- ?':
TIGARD, OR 97223
ential Recd By i � • ��
Date Reed2 2.
(503) 639-4171
.,, t 'C
Date to P - - 4, :
Print or Type bate to l /,'"; •
Incomplete or illegible applications will not be accepted P"nnit �g �
Related 5WR r:
Called nt::.
Name of Development/Project , _ _ '
.T9•�p�I ° l 7 : :ArY°r ... r- '
__a ...7„,
Job Sink
9 .00 Effa
Address s4 � '� _ SU Lavatory 91:1° / 7 f Tub or Tub/Shower Comb. lail
Bldg Stalte _72
Bld a r o ._ 99 z / Shorter OM 0,00 y;,'
N ¢ %� /� Water Closet o oo
) e rg /7 / /-7 /9t Dishwasher
9.00
G�f .:
Owner Mali AQdre 5 , �` :e > e Garbage Disposal
Washing Machine 9.00 f
723 ..:
Name
/� Floo Draln/Floor Sink 2
9 -00 d , ;.::
3" 9.00 _ *,.'t,
4- 9.00 I. } ' .
Occupant M Address Suite "
F Water Heater 0 conversion 0 like kind 9.00
Gas piping requires a separate mechanical permit. : r%x"
City/State Zip Phone .Laundry boom Tray 8.00
e Urinal 9.00
/III , (2thQ Other Fix urers (Specify) 5 onrrarrnr 22 Sup may _ eo
Prior to per F� i F'.. na �� t
` % •a _ Sewer - 1st 10 permit r - l + 3 ;;' ?`ta
issuance• a copy 0 •' �
1 ��Y'L Sauna,. each additional 100•
. .:;
..r ..8 1i..sr a l OICyu I c I ont. eso. m Lis.* p, D8 a
rc vd Ir / . L. l _ _ W M 30 - ater J
Ce - 1st 1-00' 30.00 '1" ....
expired In COT Plumbing Ic, a Water SWAMI - each additional 200' 25.00
database — 7 t �— {)j --9 Storm & Rain Drain 1st 100' '
Name ' 30.00
Storm & Rain Drain - each additional 100' 25 t '
Architect •
Mobile Home Spa
Or Mailing Address Suite m 25.00 . -.
Commensal Back Flow Prevention Device or Anti- 25.00
pollution Device •
Enaineer City /stale LIP Phone DQa1dan01.1 o
evhllovr Pry wntion Dcrlac" 1J.00
(Irrigation timing devices require a separate
Describe work to pe one: restricted energy permit)
New 0 R; r,: Replace with like kind: Yes- O No O Any Trap or Waste Not Connected to a Fixture 8 . , : -.4
Residential Commercial 0 Catch Basin '
Additional description of waif mo or r_,ou., !Numbing 9.00 i ?
K 1 LCDC,�. Il 1 i i i 1 P ® a tv.vu t!,r�e.
l j t ' ' _ vI . - ►�, J v ,LS P1)°--- 40 .00 • <x <,
, `, ' �,�, 1 U c (� �/ } � , � Specially Requested Inspeetleng 40.00 '
Q ON C fS1Ct .D- Co -B x l x.t 3 per/hr `' '
Are you capping, moving or replacing any fixtures? Gre Drain, single family dwLlling 90 ,
Yes O Noel( Grease Traps 9.00 0
If yes, sea back of form to indicate work performed by �r ' '
fixture- FAILURE TO ACCURATELY REPORT FIXTURE rn QUANTITY TOTAL F
WORK COULD RESULT IN INCREASED SEWER FEES. lsoetric ,adulree A Quanti4 s >a . ..�"
'SUBTOTAL �.,- ' t„ "?i
I hereby acknowledge that I have read MI application. that the Information
i
given is tarred 5% SURCHARGE , that I am the owner or a , orized agent of the owner, and . - `" Information that la submitted are In compliance th Oregon State laws- • � .�� , '
Sla u ner/Agent
� "` Date ( � q 'PLAN REVIEW 25% OF SUBTOTAL
' / fr -- - -,- �. -1,3 ` C I Required 0114' if lltiWre 91} . total is r
9ntaCt Perso ame AL E �i F' .,
Phone r . ;
a s5 'Minimum permit fee is 525 516 surcrtarge etas Ras n !sill':
Prevention Device, which Is 15 % a ° ' °;+t; a'' /am ' ,'4 ° `
M
All New Commercial Buildings require plans wi lsometricor.,tiser .fr'� r-
and plan review .v
sI, pwrnA e�c 7R1 •� d ;, •: 1' s } � . y' a •• • F ro , • :` ' 9 R r z , i"
.
R';. .
CITY OF TIGARD BUILDING INSPECTION DIVISION MST '
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date. Requested / AM PM v BLD
Location 7c -' Suite MEC
Contact Person Ph PLM 6635
Contractor Ph SWR
BUILDING t.: `K Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear -� `°� --
Int Sheath /Shear
Framing ,!
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm �S
Susp'd Ceiling
Roof
Misc:
A P :)AS I S PAR FAIL
Under Slab
To
Sanitary Sewer
Rain Drains
ASS PART FAIL
MECHANICAL. a „`;
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL ° ',1
Service
Rough In
UG /Slab
Low Voltage -
Fire Alarm
Final
PASS PART FAIL
Prig
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 / d �
Other Date l °` Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.