Permit CITY OFTIGARD
PLUMBING PERMIT
— Jar . � DEVELOPMENT SERVI PER #. E PLM98 -1002
PARCEL: 2S111CB -05300
SITE ADDRESS...: 10060 SW LADY MARION DR
SUBDIVISION....: ULWELLING MLP96 -0015 ZONING: R -3.5
BLOCK........... LOT.......... . :003 JURISDICTION: TIG
CLASS OF WORK.. :ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0
TYPE OF USE.... :SF WASHING MACH......: 0 BACKFLOW PREVNTRS..: 1
OCCUPANCY GRP.. :R3 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....: 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 0
DISHWASHERS....: 0 RAIN DRAIN (ft)...: 0
Remarks: Residential back flow prevention device.
Owner: FEES
CASSY NOSLER type amount by date recpt
10060 SW LADY MARION DR PRMT $ 15.00 DLH 08/18/98 98- 308351
TIGARD OR 97224 SPCT $ 0.75 DLH 08/18/98 98- 308351
Phone #: 624 -0889
Contractor
TREE CARE UNLIMITED
P.O. BOX 1566
LAKE OSWEGO OR 97035
Phone #: 635 -3165 $ 15.75 TOTAL
Reg #..: 000056
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP /Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
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- m1 -0010 through OAR 952-1 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987. .
•
Issued By: ,�1� ___ Permittee Signature :!'1 ` /L�.C' _/
1 /9 d.. i°70rv
++ + ++-f 4— ++++++ +=1 f + +=i * +i +++++++++++++++++++++++ + + + ++t + + ++ + + + ++ + + ++ + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for an inspection needed the next business day
+ ++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
3/98 THU 14:31 FAX 503 598 1960 CITY OF TIGARD QC !/ uuz
r -JF TIGARD plumbing Permit Applicatio�iVED Plan Check#
Ipillir
3125 SW HALL. BLVD. �' o' Commercial and Residential Rec'd By c2;?t-1...14
TIGARD, OR 97223 j t -_ AUG 1 7 1998 1 � te Rec'd ?Mr,. .
(503) 639 -417 Da to P.E.
Date to DS
Print or Type COMMUNITY DEVELUri.u Perms /' T 'lDD�,
incomplete or illegible applications will not be accepted
Related SWR #
// 5 7 7- D ,z 9 3 Called
Name of Development/Project tn3 "ii 11 #0MPA) �E'ci It�tis =`= =a';;li; = li } ' `: .'3".� }'fXr _(. p,t�. ICEsr-='rYKtSAT' >ti
.+ . -•� ., ..+ r,:: r? t .1riE::: = ..,,-- .. !r.- ..::Li.G - , 37.. ,...g.,- .�tti.:�...)= ::.m:e�rpt :..at::::o;: �:.
Job Sink 9.00
Address Street Address 1 Suite . Lavatory 9.00
1064,660 L4cfy N/4f`it114 Tub or Tub /Shower Comb. 9.00
Bldg # Ctty /State Zip Shower Only 9.00
T' 14(s3 f3R. 9 ?-27 )H Water Closet 9.00
Name 1
CA/Jsi) NOS /e. C" Dishwasher 9.00
Owner Mailing Address Suite Garbage Disposal 9.00
/Op(oO S &) 44ciy 'i4Nok Or- Washing Machine 9.00 '
City /State Zip Phone
r Floor Drain/Floor Sink 2" 9.00
Ti m-4.O R 9 61 0 i30 7 2" 9.00
Name
SAM-e.. 4 " 9.00
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
- Urinal 9.00
Name
�/�22lATe A , f _ f Other Fixtures (Specify) 9.00
d i N� r T�CJ .
Contractor Mailing Address Suite /NCB 9.00
P.O. i 7 6.4 v34,. 4 9.00
Prior to permit City /State Zip Phone ' Sewer- 1st 100' . 30.00
issuance, a copy IA k< e ,3 97 lo3la=3I1p5
fit' Sewer - each additional 100' 25.00
of all licenses are Oregon Const. Co Board Lic.# Exp. Date
required if !02 6 3 S ,/ .q /C) I - d 6 r/� Water Service - 1st 100' 30.00
expired in COT Plumbing Lic. ;* Exp. Date Water Service - each additional 200' 25.00
database -VP S 5 G 9A).14 (
(9 Storm & Rain Drain - 1st 100' 30.00
Name Z f /30/99 v 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 Backflow Prevention Device' i 15.00 /
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.)
New X Repair 0 Replace with like kind: Yes O No O Any Trap or Waste Not Connected to a Fixture 9.00 j
Residential 0 Commercial 0 Catch Basin I 9.00 I
Additional description of work: Insp. of Existing Plumbing • 40.00
per/hr ,
Specialty Requested Inspections 40.00
per/hr
Rain Drain, single family dwelling 30.00
Are you capping, moving or rep) ing any fixtures? -
Yes O No Grease Traps 9.00 •
If yes, see back of form to indi a work performed by yttq .- _i;_ t __ ^
QUANTITY TOTAL ;? _:iM :. ;
fixture. FAILURE TO ACCURATELY REPORT FIXTURE << > , : _I1C " nr -
'
Isometric or riser diagiem is require d Q uan tit y T o t a l i s > 9 ic r. � = ._;
*SUBTOTAL _ ° ':'•N-q -}I �`
WORK COULD RESULT IN INCREASED SEWER FEES. r o ?=
I hereby acknowledge that I have read this application, that the information l:�dt:�: �Ns�z- �= :;:a /C. 0
given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE �"'"-" ",y'' !'. , 7S
That plans submitted are in compliance with Oregon State Laws. n ,;,;; ; s' :8,, .' - _.,
� � 9 "PL AN REVIEW 25% OF SUBTOTAL '"" `�' i ii i il' `
nature of weer /A ent Date ��'" i� � .
- )3 4 ‘ Required only if fixture qty. total is > 9 ,..... . �ta >,._- :...
TOTAL s,3.,t:;,� �:i = � � s . Contact Person Name Phone _� ; ;:bit,.- ; �iT;:,,
-� _ *Minimum permit fee is 525 + 5% surcharge, except Residential Back
M �®S�r"S & «' 3/(05 Prevention Device, which is $15 + 5% surcharge
"All New - Commercial - Buildings require plans - with isometric riserdiagram -- - ---
and plan review
lldsts\G+napp.doc 7/2/99
11U6-13 -1998 14:40 503 598 1960 97% P.02
CITY OF TIGARD BUILDING INSPECTION DIVISION ok MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
53 Date Requested � ‘9 AM PM BLD
Location (0060 S W *AI U Suite MEC
Contact Person C ?),XYL . Ph (O 3 5 — 3(65 —
ap Le - fV O�
Contractor Ph SWR
BUILDINGF , r , Tenant/Owner ELC
Retaining Wall ELR � - / 0`7,5/
Footing D,� ,�, /�/9
Foundation Access: ethz Q �1VV (� ��(}'t P
Ftg Drain U
Crawl Drain Inspection Notes:
SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Fre -ming
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
�.A8S PAR t FAIL
� ,,PLI:JMBING��
Post & Beam
Under Slab
Top Out
Water Service O
Sanitary Sewer
Rain Drains
PAS PART FAIL
MECHANICAL'w °y ry .; ° �
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL: r#
Service
Rough In
UG /Slab
cow Voltage)
Fire larm
PA ART FAIL
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
Other oach /Sidewalk Date ? ,_?C� . Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job. site.