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Permit CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM1999 -00439 " ' - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/20/1999 SITE ADDRESS: 09700 SW MARILYN CT PARCEL: 2S111 BD -00412 SUBDIVISION: DARMEL NO. 3 ZONING: R -3.5 BLOCK: LOT: 029 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 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 electric water heater w /new gas water heater. FEES Owner: Type By Date Amount Receipt DAVID HATHAWAY PRMT DST 12/20/1995 $50.00 99- 320553 9700 SW MAR CT 5PCT DST 12/20/199E $4.00 99- 320553 TIGARD, OR 9722722 4 Total $54.00 Phone 1: 503 - 968 -8208 Contractor: SPECIALTY HEATING + FABRICATIO 9528 SW TIGARD ST TIGARD, OR 97223 REQUIRED INSPECTIONS Phone 1: 620 -5643 Misc. Inspection Reg #: LIC 00066578 Final Inspection PLM 37 -427PB Oi G Ms. 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. Issued B ��� Permittee Signature: %/ /A f 5 Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check# 13125 SW HALL BLVD. Commercial and Residential Rec'd By TIGARD, OR 97223 Date Recd (503x639 -4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit # ®ew1i99 • Related SWR # Called Name of Developm nt/Project FIXTURES (individual) QTY PRICE AMT Job 4)4440 AiAdar Sink . 11.50 Address Street Address ` � Suite Lavatory 11.50 7,2 -s / I [LN vel Tub or Tub /Shower Comb. 11.50 Bldg # C i /State / rrJ� Z 7� I i/ Shower Only 11.50 � T Water Shower O Urinal (Specify) 11.50 Nls� , / '" % Dishwashe 11.50 Owner Mailino , Address /' Suite Urinal 11.50 97 Q SW 11 /G�q{7 Garbage Disposal 11.50 Ci eo� 4E 7.2..74 e / e Pone Laundry Tray 11.50 Illy/State N me Washing Machine /Laundry Tray (Specify) 11.50 Floor Drain/Floor Sink 2° 11.50 Occupant Mailing Address Suite 3" 11.50 • 4" 11.50 City /State Zip Phone Water Heater conversion 0 like kind /I 11.50 _, _ __ Gas piping re Ices a separate mechanical permit. 1 -QC! �j_1 MFG Home New Water Service 28.00 Contractor Mailing Address SuRe MFG Home New San/Storm Sewer 28.00 p / ¶ 71q d Hose Bibs 11.50 Prior to permit /State 4 Phone Roof Drains 11.50 issuance, a copy / l e jcC QiC �p Q p �2 7,3 4;10 -66 Drinking Fountain 11.50 of all licenses are e on Const. Cont. Board Lic.# Ex ate / required if a..578'` //( 4l Other Fixtures (Specify) 15.00 expired in COT Plumbing Lic. # Ex Date) database 379 -/2 7A6 y �3dl oo Architect Sewer - 1st 100' 38.00 or Mailing Address Suite Sewer - each additional 100' 32.00 Water Service - 1st 100' 38.00 Engineer City /State Zip Phone Water Service - each additional 200' 32.00 Describe work to be done: Storm & Rain Drain - 1st 100' 38.00 . New 0 Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00 Residential " Commercial 0 Additional descri tion of work: Commercial Back Flow Prevention Device 32.00 hie) dii � � ✓� Residential Backflow Prevention Device' 19.00 � N ,• t r � Catch Basin 11.50 Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00 Yes 0 No 0 Inspections per/hr If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50 WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL 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 © - that plans submitted are in corn liance with Oregon State Laws. / 7 Slgrtatyre of caner /Agentp� f /,t /9 / 8% SURCHARGE Con arson a Phone - MO "PLAN REVIEW 25% OF SUBTOTAL 1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9 2 BATH HOUSE $250.00 TOTAL g 7, f' .. 3 BATH HOUSE $285.00 • e(This fee Includes all plumbing fixtures in the dwelling and the first 'Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention 100 feet of sanitary sewer storm sewer and water service) - Device, which is $25 + 8% surcharge "All New Commercial Buildings require plans with isometric or riser diagram and plan review. I:ldstsVormstplumapp.doc 9/30/99 - -. PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved I Replaced Removed /Capped Sink Lavatory Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Urinal Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I:tdsts formslplumapp.doc 9/30/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 a �/l 2 ; BUP Date Requested 1 ap -/ g AM PM BLD Location 9 700 MRAit IA CA— Suite MEC G p Contact Person Ph l� Z O - S Lo t i 99 ? PLM 1 —0 2 ? Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Ac cess: g( Foundatio FPS Ftg Drain (� SGN Crawl Drain Inspection Notes: /', / — � Slab Y t 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 <LUMBIRIb Post & Beam - Under Slab Top Out Water Service . Sanitary Sewer Rain Drains 0r PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL CC) 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 3(,-) Other Date / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.