Permit A CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERM I T 8 / 9 99— ���
- DATE ISSUED: 02/18/99
PARCEL: 25110CA -00200
SITE ADDRESS...: 11965 SW KING GEORGE DR #008
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 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 SPCT $ 1.25 B 02/18/99 KING CITY
Phone #:
Contract or
HYDRO TEMP MECHANICAL INC
28465 SW BOBERG RD
WILSONVIL.LE 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 /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 ®ore
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- „.:s. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
Issued By :V° `f' l Permittee Signature :l It 'rrllm - -(M
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
""" ; JAN -07—' 00 SAT 00:45 I D: FAX NO: 1:1009 PO4
Permit Application x"
CITY OF TIGARD Plumbing PPl icatlon
93126 SW HALL BLVD. f- " `'t'° • " : . > AK ,
Commercial and Residential R ece B i► ; a�Y= `'
TIGARD, OR 97223 By ,T� Wit,,, �!!��
Date Recd ,Z yfasts' • ;;.'vii,' {fy
(603) 639 -4171 Date to P.E.
4 z,
- Print or Type Date to osT
Incomplete or illegible applications will not be accepted Permit -
Related SWR a
Called r
Name of Development/Project -7 7`; -. 5' , i Fi i ,L', , r_ 17; p `''' 7-'1,'"-r-
Jut, t '
Address Addre Sint lavatory , a m Emu
7 (! X12 C, 900 Inn
Tub or Tub/Shower Come_
Bldg it . � C./ Slate Shower Only � 9_00 � �
Na �� Water Closet 9.0
fit: ei d/a' / ' e Dishwasher _ 9,00
Owner Mizq Add re :fie Garbage Disposal 9.00
C:y
� Washing Machine � 9.00
"¢ ?} Scat 2Jg J 4.1 Floor Drain/Floor Sink 2" 9.00 MEM
Name 3" 9.00 -
e' 9.00
Occupant Maltin Address Suite Water Heater O converalon 0 like kind
9.00
Gas +• re. ulrea a SC • rate mednantcaI • -
City/State Zip Phone Laundry Room Tray 9 00
Uttttal 9.00
Na e ✓1� -Temp i�2e w
/ J) J - Te / Other F inures (Specify) 9,00
Contractor M,alli; • ' 'r5 �%In �
/ IEMT0��® :15
i • e,00
Prior to permit Ci / to / i ?L/ :517,34:,.. y Sewer - 1st 100'
issuance, a copy Vii te, 7 /li
of all licenses are dreg G t nt. Board Lie.* Exp Sewer - each additional 100' _ 45.00 ,; ,,,,
required if /� Water Service - 1st 100' 30.00
expired in COT. PlumbinA tic, S Date tn � Water Service . each additional 200' 25,00 EMI
database 10 — c3 3 7 7 9 - Sloan & Rain Drain -1st 100'
30.00
Architect Name
Storm & Rain Drain - each additional 100'
2540 IIIII
Mobile Home Space 25.00
o Mailing Andress Suite Commercial Back Flow Prevention Device or Anti- p 26.00
Pollution Device
Engineer °b./Stale Zip Phone Residential Backflow Prevention Device' 15.00
(Irrigation timing devices require a separate ■
Describe work t0 one: restricted ene • • - IL
New 0 Rep Replace with like kind: Yes 0 No 0 Any Trap or Waste Not Connected to a Fixture 9.Q0
Residential ommerrlal 0 Catch Basin 9.00
Additional ascription of Work: r�r�
la. lab e D tom• - into, of Existing Plumbing 40.00 �, n
� • : r/hr �
4 /i c �j fj . Ai 1/ � /r piP-`-- Specially Requested Inspections 40.00
Are you capping, moving or replacing any fixtures? Rain Drain, single family "veiling 80.00 :.
Yes O Not Grease Traps 0,00
If yes, see back of form to indicate work performed by • , q �
fixture. • FAILURE TO ACCURATELY REPORT FIXTURE nUANTITY'rOTAL
WORK COULD RESULT IN INCREASED SEWER FEES, QUANTITY
Or riser = .rum is require:H Q -. , Tow v > 9
I hereby acknowledge that I have read this application, that the Information "SUBTOTAL ,
given Is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE 7 - - .
that • lan,• itted are In com • Nance with Ore. • n State Laws, ' ; ';
Sign- re o Own /Agent _ Date �. -.2. O ` - _
. PLAN REVIEW 25% OF SUBTOTAL C ''
• I' / .4 ') 'j . •9g R -•u �. i•..r ! 1. a
e.i •u kflw is >
co l / \ nl c ///J�j(�/yJ e � rso a- I U I AL ! F '
0 f! ' � 5 Minimum permit fee is $25 + 5% surcharge, except Residential 8ackfloste,Y d•J.:
�1 ! 1.� Prevention Device, which Is $15 + 5% surcharge .: "..: ':fiiy::. ;j i, ' ;
"All New commercial Buildings (squire plans with isometric or riser d d • •; .:.
and plan review
' u, itpp,doG TI2/98 . ` ; T ' ' ,
ate m d rt 1i� •
i:: "f',
CITY OF TIGARD BUILDING INSPECTION DIVISION MST J
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3// AM PM BLD
Location / 1 �� a ° ; Suite MEC
Contact Person Ph PLM q 6 ' 6 -35
Contractor Ph SWR
BUILDING F ? g ,,'4' 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
Susp'd Ceiling - l
Roof
Misc:
Final
PAS FAIL A r f�
UMBING`
P Rrarr
Under Slab
To. •
am - er
• rains
4' PART FAIL
MECHANICALr` ` s
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
• PASS PART FAIL
ELECTRIC =°
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE; qk.s,..
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 3 /?Y Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site