Permit CITY OF TIGARD PLUMBING PERMIT
`^ ; DEVELOPMENT SERVICES DATE ISSUED: 02/ 18/9 -0041
13125 SW PARCEL: 2S110CA -00200
SITE ADDRESS...: 11945 SW KING GEORGE DR #004
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. Install 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
REG!UIRED 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 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)246 -1987.
•
Issu-ued By: 15 4 Permittee Signature:el/V / 1# \('44JIYh r 0
1
--+++++++++++++++++++++++--+++++++++++++++++++++++ + + + + + ++ + + + + ++ + + + + + + + ++ + + ++ + + + ++ - -
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++- I-+++++++++++++ + + + + + + + + + + + + + + + + + + + ++ + + + + + + + + ++
JAN- 07 - '00 SAT 00:49 ID: FAX N0: 14009 P06
CITY OF TIGARD : * ;Y`0
Plumbing Permit Application i '' :, :..,
13125 SW HALL BLVD. Commercial the ;:P ; : , . • mercial and Residential Recd By N . 4.1 , ?, ;t .;
TIGARD, OR 97223
Date Recd 12 t.
(503) 639 - 4171
Date to P.E.
• Print or Type Date to DST - ;..ti:; .
Incomplete or illegible applications will not be accepted Permit * - 1914411 . ' .
Related SWR s •
Called • . •• $:' <;,
.
Name of Qevelo
Job prrtent/Proled �4e�+ I s "P z t ti + fig J`'' Mw ;777'7177-7" r ,.._ : = 'i - ' -, . —
L 9.00 ;
Address 17 . 41 „, 4 ,s ,:( ,,, . t<7 . i $urtp � Lar aly,y iiii
y 9.0
• 81dy I Sire 4-1922,1Y _ - lib orTub/Shower Comb. 9.00
�� Shower Only 9.00
N a y Water Closet 9.00
At L..' -. 4ri._ i i a l.i1 ' Dishv,rasher 9.00
Owner
;Pre,1,6-- / p_ 'in. Carbaye lYaYwa� _ !8 a r � �Xl Washing Machine 9.00
r U�: Phone �� 7 � Z ,,e ti ^�1 /✓3 Floor Oratn/Floor Sink 2' 9.00 a:: • ::
Name 3" 9.00
4' 9.00 :i ?i:;':
Occupant Mailing Address Suite water Heater 0 conversion 0 like kind 9.00
Gas piping requires a separate mechanical permit_ •
City/State Zip Phone Laundry Room Tray 9.00
N � Urinal .9.00
.1, .0 •• r�,1/ I i li �1n� Other Fixtures (Specify) 9.Oo
Contractor iii ,f gees tai f r' ,,;te �.� ibrmi - -P' . 1
. - , /(fi
Prior to permit Ci /tats _z p 8.00 !
,s;uance, a copy / � x1r11l Gam `7f 40 ~ ee - ra, loo'
30.00- • : _
'-""-` 1S J Sr S Sewe - each 100' 2g 00 "
of all licenses are Oregon 7on5L - ant. Board Lic.* xp t . 0-7 Water Service -1st 100' 30.00 • + ..
expired In COT Plumbing Lie. Exp. Date Water SenMce - each additional 200' 25.00 -
database .x -- c, - 5 57 Pe - 7 3 I -- q l q Storm & Rain Drain - 1st 100' 30.00
Name Storrn R Rain rL*in - .iawl, :..td::or.at •roo' "1<e_oo
Architect Mobile Home Space 2500
Or Mailing Address Suite Coercial Bak Flow Prevention Device or Anti- 25.00 • i - .
P nW m A l m nn ..,
Enginr,ar I Girwbrete 7ir, ("hono rlaiuti oacxnow I reventien Device' 16.00
(Irrigation timing devices require a separate
Describe work to b • one restricted energy permit) .
New 0 Rep- Ir 1 Replace with like kind: Yes 0 No 0 Any Trap er Waste Not Connected to a Fixture 9.00
Residential • ommercial 0
Catch BaSln • A rtionai • ascription of work 9.00 • _� #.,11nstai,1 QId • Insp. of Existing Plumbing . 4 0,00
- pt , -'L•'
� rr �) 1 'pc_ - Speelally Requested Inspections 40.00 _ •
SO S 10 • ,. Tl '11 - , rrhr
Are you capping, moving or re 4cing a fixtures? Grease Drain, single family dwelling 30.00
Yes Q No Grease Traps 9.00
If yes, see back of form to indicate work performed by
fixture. FAILURE TO ACCURATELY REPORT FIXTURE QUANTITY TOTAL t °; F '.? ` .^ Fi ,- , >j
WORK COULD RESULT IN INCREASED SEWER FEES, lsorttel or riser el : •run is required If Quern BT Total le ? 0 i7`
application, I hereby acknowledge that I have read Ihis a "SUBTOTAL f, ' f °�
Ivan pp that the information • given is correct. that I am the owner or authorized �'':
ed agent of the owner, and �` 1 * �� = '`� "�` `� �� I • that I s submitted are , n wl reg State Laws. b% SURCHARGE " = � , •
S I of Ow -r/AgI Date '; T. ";;L,:,._7: ; .. r�
I �1 f�(� " PLAN RE 25% OF ; -- .... � ..,
� ' a 7 F SUt3roTaL au:: •• :
- Require drily it fuAure qty, total Is > 9 - • .y . : }. . c� .,
contact POlv •,rl. Li . TOTAL- ? ", -..., s',r ��: • ` ". ',• �- I •
New Commercial Buildings Q_ f � • v "� K 5 0 - -
. s ( 1- - 'Mmum e fee is 25 -5
t;A � .x..l � �-.� p 3 9 rrh excep Residentil a Badcflort i' ;T`r.
Prevention Device, which rs $15 r 596 9u su t '' '•; ' ' �':• <r�: :
"A
ll s '''
g requir pfels With Isometric or riser ' ir! ram .
and plan review i:,�,1,
•
• ri\olurnM _ ;'r•• .:' .'- /.:,fyy,,. lk,"'!A. ..
•
. _
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST AI_
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUPKW
Date Requested . / AM PM BLD
Location / ( � � �� Suite MEC
Contact Person Ph PLM Q e3
Contractor Ph SWR
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 C,G-c-
Susp'd Ceiling
Roof
Misc:
Final
T FAIL
11111111111MEMIE.
Pos - -m
Under Slab
To. • ..-
Crary Sewer
Rain Drains
F-in
AS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL lea . -,•
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 / j�
Other Date (? (r _ Inspect , r E
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.