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Permit
CITY TIGARD PLUMBING PERMIT I DEVE LOPMENT SERVICES PERMIT #: PLM1999 -00185 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/16/99 - SITE ADDRESS: 09495 SW LOCUST ST A PARCEL: 1S126DC-04800 SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P BLOCK: LOT: 004 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Replace existing water heater w /like kind. FEES Owner: Type By Date Amount Receipt MBM &ASSOCIATES PRMT DST 6/16/99 $50.00 99- 316164 9495 SW LOCUST STREET MISC DST 6/16/99 $2.50 99- 316164 SUITE A TIGARD, OR 97223 Total $52.50 Phone 1: Contractor: KENNEDY PLUMBING 13985 SW FARMINGTON RD BEAVERTON, OR 97005 REQUIRED INSPECTIONS Phone 1: 643 -5535 Final Inspection Reg #: L I C 001009 PLM 34 -42PB ORIGINAL This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other 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 - 0001 -0010 through OAR 952 - 0001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. / .4e; Issued By: Permittee Signature: • Call (503) 6 -4175 by 7:00 P.M. for an inspection need - e next business day - I A r „s._.p�s ' " ,� i t -3 x .,- ` f'*' y` r `` P l um bin g Permit Application CITY. © F"TtG ARD 13ri SW HALL BL D* - a , • mmerclai and Residential P TiGARD, OR 97223 4 " �"' `: : :_: , ' R i . , *, ii n4 (503) 639 -417 .p Y r L Pant or Type . �G P4 r iQ9 0 N f . ._ , ,_ '6ii ill • pplt ttion# not be ,. . ( �, + !� .z4.�. Ti. J,...• r y Y M1 '4.'�. :'Y""4 s w "+t '4 "x ,�„ -. ' u- rd, E fi :.,, y '� �' 4 ,c'. - , k ., nit t +' _ , .- h � � � � w }e � ,./,,-,,,,,,, � h _ S..N � . to e. ..- . u . .? .1 �. _ � � � ef b',F JF, I =IX'FUI ES 3adtvtdual} s flT > , I OE AMT # Name of Development/Project :' .• ,..: . Sin 11.50 • .. Job aNe In 4 a6 SOC 11.50 S treet Address ! Suite Lavatory Address ct 1 1C 5 50 I oc. b+ St _ Tub or Tub /Shower Comb. 11.50 Bldg # I City /State Zip Shower Only 11.50 l <<q Or rd -12. Water Closet 11.50 Name Dishwasher 11.50 Suite Garbage Disposal 11.50 Owner ailing Address l 11 50 - q 5 �}{�, J t _ Washing Machine City /State Zip Phone _ _, 5 Floor Drain /Floor Sink 2° 11.50 Clr� �� q?.t�3 aZJ�� - �J 3 . 11.50 Name`s 4" 11.50 ' Occupant M Address Suite Water Heater 0 conversion 0 like kind 11.50 f t , 5 Gas piping requires a separate mechanical permit. 11.50 t �� City /State Zip Phone Laundry Room Tray ', Urinal 11.50 ,. ..,.. Name Other Fixtures (Specify) _ 15.00,....- Contractor Mailing Address Suite „ 13e1 s 5 S 4. r ^ �Fo►'� Prior to permit Cl /State Zip ,, Phone' S � Sewer . 1st 100' 38.00 issuance, a copy .43 v4, -� c7 oc 5 1:4 3' Sewer- each additional 100' 32.00 of all licenses are Or on Const. Con . Board Llc.# Exp. Date Water Service -1st 100 38,00; required if Li - 44 2.Q� . : ; , expired in COT Plumbing Lk. # I O j ..Exp. Date Water Service - each additional 200' 32.00 database Storm 8. Rain.Drain -1st 100' 38.00 r - Storm?& Rain:Orain eiach additional 100' s 32.00 Moblie�Home ry R y�` 32.00 , . ; Architect - , ' •: � '..:::V.15-:;'-'1) , � - ..... � ;< '. ' M Address Suite Commercial Back Flow Prevention Device or Anti- 32 .x' Or _ Pollution Device Engineer .,City /State ---- < . . . Zip --, - - Phone Residential Backflow Prevention Device* 18.00 (Irrigation timing "devices require a separate restricted energy permit)._ 11.50 , i Nescribe:work to be done ;,, .Any Trap or Waste Not Connected to a Fbcture New CO ` ` Repair 0 Replace with like kind ' n =Yes �O No O 11.50 t Residential 0 Commercial 0 Catch Basin Additional description of work: lnsp. of Existing Plumbing per t /hr Specially Requested Inspections 50.00 Are you capping, moving or replacing any fixtures? per/hr P Yes 0 No 0 Rain Drain, single family dwelling 45.00 if yes, see back of form to indicate work performed by Grease Traps 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL [:-U6 rH P I i hereby acknowledge that I have read this application, that the information Isometric or riser diagram Is required if Quantity Total is > 9 given Is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL 50, 0 that plans submitted are in compliance with Oregon State Laws. 5% SURCHARGE Signature of Owner/Agent Dete �� .Z 5D Pon b * *PLAN REVIEW 25% OF SUBTOTAL : Contact P on Name b'L 5` q > 9 ., .; . � . , . " „„ j .. Y4 ., q ar:or .; •y •;:' ,` Y� . ;, .. Required only fixture qty. i• TOTAL 4 J ' , � ��.. a uke n it a .total �, �0. rat, , ., h ,�.:: r ....$. Y. :0.30 , �s ,:;F�iil'6:17l;{ +. �i. ;. +. 4 ? T;: • � G �;::n�.3. <Sx.....i ;:- • , �:��xa ��ns•!o >:ti :�t?�... T 4>Y 8 : r`.. •: ?'+:. <r..:<`' t tic K y ; ^`' k + :6 0,11 :� • 400 4 ' z .` , `$ 0 ?s'£?' *Minimum permit fee is $50 + 5% surcharge, except Residential Backflow •,+��,' ->fi�'M1 , +,+ . � %+k� ��hv,j..' ,� K Y , > . $ � ± � K .. �+/ + ° 9 s ' • •fi'� >�• " • � �'' Prevention Device, which is $25 5% surcharge }; :.,.. • ,. n x : ', : a i +iv,•+ • Sit ;�; ;>,+{'.., ..`s } "'1`. gin • :: j 11 44 } ** z, - :v. .,•" ..�, . {� z,,P} ,+ s + ,4 All New Commercial Buildings require plans with isometric or riser diagram 4. f ' '?› -.I: i ,w 's.i.° . s,. it ... »,:LN. as ....... .4.,..::::).A': X ,;,° • and plan review ladstslfcrmslphenepp. doc 5128/99 ---- rr ... 7 r rte. .,nn, nc.n ono A Ve'TT T?T.r RR /Q7 /Cn CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested (/� OD AM PM BLD Location q 9 S l ANS MEC Contact Person ` S QL " - U Ph q 'S c iq 9? "C:0/ Contractor Ph SWR BUILDING Tenant/Owner111.11.1110100 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 Roof Misc: Final PASS PART FAIL I IMRINe Post & Beam Under Slab Top Out Water Service Sanitary Sre / R Drairt - 47 PART FAIL HANICAL 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 Date ` ) 0 Inspector Ext Other 14 I Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.