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Permit CITY OF TIGARD t-,�;„,...,,,• ,� DEVELOPMENT SERVICES PLUMBING PERMIT i �' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # : PLM97 - 0426 DATE ISSUED: 10/30/97 PARCEL: 15136AD -04000 SITE ADDRESS...: 11525 SW PACIFIC HWY SUBDIVISION : VILLA RIDGE ZONING: C -G BLOCK LOT :007 JURISDI TION: TIC CLASS OF WORK..:ALT GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE :COM WASHING MACH 0 BACKFLOW PREVNTRS..: 0 OCCUPANCY GRP..:B 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. • 1 OTHER FIXTURES • 0 TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0 WATER CLOSETS.: 1 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Fast Signs tenant improvement replacing both fixtures Owner: -- - - - - - - -- - - - - -- FEES -- - - - -- -- - -- ' FAST SIGNS type amount by date recpt 11525 SW PACIFIC ' PROT $ 2�. 00 DRA 10/22/97 97-- 300287 TIGARD OR 97223 SPCT $ 1.25 DRA 10/22/97 97- 300287 Phone #: Contractor MODERN PLUMBING 11120 SW INDUSTRIAL WAY TUALATIN OR 97062 -- --- - -- --- -- --- - -- -- Phone #: 691 -6166 $ 26.25 TOTAL Reg #.. : 000879 REQUIRED INSPECTIONS --- - - - - - -- This permit is issued subject to the regulations contained in the Top-out Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Insp exist in/ca 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 - %1 -0010 through OAR 952 - 0001 -0080. You say obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. - i r � ri/ Issued By: - �' Peri ittee Signat�-rr^e:�. _ +- F + + + + + + +•f- + + + + + + + + +-!--- + ++ - r- +++++++ + + + + + + + + + + + + + + + + + + + + ± + + + + + + + + +4 - + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next buusih,.ss day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + ++ + + + + + + + + + + + + + + + + + + + + + + ++ ■- -. _. CITY OF TIGARD Plumbing Application ,2 li Rec'd 4 4i -' , 1:2 Date Rec' /D -,44 13125 SW HALL BLVD: • Commercial and Residential % 4 Date to P.E. TIG 9, (7R 97223 r '!• Date to DST (503) 639 -4171 fl,� , �, a Permit # PLr�+97-a/z ( Print or Type K ji - " Related SWR # -. )1476 9 7. 0'3 . 7 - t'Ke j Incomplete or illegible applications will not be a Called / OFc/ F c-1 T& Name of Devlo ment/ ro ect r �� c , �a 1, = - . • Job - .'4. -•/ .14 � h ; v''�v , ° . ' - ,.. , , y i 1 - 4 ` L� , 1 r , “ 4 ( , 5 .u � t ' .• r e 5+• id ` - !i_ S �1�J 4p BATH -HO r SES140.OD ryv4` ° x ■ - • US 319500 ,i :,-�. Address Street Address Suite ,,it 1 � ;a'k Ok313ATH HODS 225.00' '� ` x ,. '11'1-1-'4 , • 1 ', ' +- P wti. .s. gill jan••the 00.feet. ' !' R ' , 112.S vJ PIaGC -+C. w Fee'.Irii�udes,all: umb���f bitures�n'thedwell �F�' Bldg y biller 89rvCe + ` r. » vsa .o... •.. xn .... . ' g City /State A Zip sariltaryseWer ,andstomisewer,��',Seeaees` •=low i � • ' � �..L ��� \`� G. ••••'ayr•3 -•,-- - i� • • . . • ..nw� •�r1, 9 r � */; U ;a,. r M%0p4 mt PbcLl4 FnW%:- ;NV.r. ' :4 l L - y, r : f • •=x.• Name FIXTURES (individual) QTY PRICE AMT Sink 9.00 Owner Mailing Address Suite Lavatory 1 9.00 C,, - Tub or Tub /Shower Comb. 9.00 City /State Zip Phone Shower Only 9.00 Name Water Closet I 9.00 Q -- Dishwater 9.00 Occupant Mailing Address Suite Garbage Disposal 9.00 Washing Machine 9.00 • City /State Zip Phone Floor Drain 2' 9.00 Name 3' 9.00 4' 9.00 Contractor Mailing Address t Suite Water Heater • 9.00 1 W? C' 'W .. rNaL.V.S\ C 1 • Laundry Room Tray 9.00 C /State Zip Phone Urinal 9.00 Oregon Const. Cont. Board Licit Exp. Date Other Fixtures (Specify) 9.00 Attach Copy of -) CI u i o I Z _ ‘ cg -S -) 9.00 Current Plumbing Lic. # Exp. Date • 9.00 License 9q•25-1Z) ? \Z- \ct -cif Sewer - 1st 100' 9.00 COT Business Tax or Metro # Exp. Date . ZLt et. 1 - k - et Sewer- each additional 100' 30.00 Name Water Service - 1st 100' 25.00 Water Service - each additional 200' 30.00 Architect Mailing Address Suite Storm & Rain Drain - 1st 100' 25.00 Storm & Rain Drain - each additional 100' 30.00 or Engineer City /State Zip Phone Mobile Home Space 25.00 9 Commercial Back Flow Prevention Device or Anti- 25.00 Describe work New 0 Addition 0 Alteration p Repair 0 Pollution Device to be done: Residential 0 Non - residential 9 Residential Backflow Prevention Device' 15.00 Additional description of work \ Any Trap or Waste Not Connected to a Fixture 9.00 �(',.,,, CA- .,\ � %7 `ro Catch Basin 9.00 Insp. of Existing Plumbing 40.00 per hr Existing use of Specially Requested Inspections 40.00 building or property per hr . Proposed use of Rain Drain, single family dwelling 30.00 building or property Grease Traps 9.00 Are you capping any fixtures? Yes 0 No p QUANTITY TOTAL I r -�T Isometric or riser diagram Is required if Quanity Total is > 9 ± s I hereby acknowledge that I have read this application, that the information *SUBTOTAL «;:i °. r'. 'K , given is correct, that I am the owner or authorized agent of the owner. and L- Ny � - - ;:- 5 that plans submitted are in compliance with Oregon State Laws. 5% SURCHARGE v ' ''is r14 J�x Signature of Owner /Agent ,. Date x ; - 'k \/r �t t ,(\., `C) 21-41 PLAN REVIEW 25% OF SUBTOTAL ° "`: Required only if fixture qty. total is > 9 � . ' ` Contact Person Name Phone TOTAL " " " 1` �; \ �Z 1 O Z I - ll ..1-.x, ., z",... r.,, 0 ,"' 'Minimum permit fee is $25 + 5% surcharge, except Residential Backflow I:ldsts\plmapp.doc Prevention Device, which is 515 + 5% surcharge • 9 Jy V k j CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: / IO" l l J A.M. P.M. MST: Location: I ! JC ? 5 5tf) /2. (,( ' BUP: Tenant: Suite: Bldg: MEC: Contractor: / % !:.._.., - /A___! Phone: 5 x—© 7/1 PLM: (37-6 C P Q Owner: _I . , API _ Phone: / -- / • / ELC: ,_ � . -- sir/. . tr .�_ i ark// 70 ELR: C BUILDING G (con't) PLIIMBING� I /. MECHANI AL �� ELECTRICAL 9 1 SITE Site Post/Beam PiWitmeam /� ostBeam Cover /Service Sewer /Storm Footing Roof UndFl/Slab. a +ough -In Ceiling Water Line Slab Framing Top Out I Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer / � Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm y Furnace Temp Service MSC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm CrawlIFound Heat Pump Low Volt Approved Approved Approved Approved Appr /Sdwlk Not Approved `o ved Not Approved Not Approved Not Approved FINAL / (� FINAL FLNAL FINAL • O Call for reinspection O Reinspection fee of $ required before next inspection El Unable to inspect Inspector: d%72..• Date: //2 7 Page 7 of 7 • Page No. 1 CASE HISTORY FOR CASE NO.: PLM97 -0426 FAST SIGNS 11525 SW PACIFIC HWY 12/01/97 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ---- --- -------- --- PLMC003 Application received / / / / 10/22/97 PASS DRA 10/23/97 JD PL14C005 Permit Created / / / / 10/23/97 PASS JSD 10/23/97 JD PLMC040 (F) Ready to issue / / / / 10/24/97 PASS JSD 10/24/97 JD PLMCO50 (F) Issue permit / / / / 10/30/97 PASS V 10/30/97 BON PIl4C725 Top -out Insp 10/23/97 / / 10/28/97 PASS MS 10/29/97 J•H PLMC760 Insp existing /capped fixtures 10/24/97 / / 10/28/97 Inspector notified customer that permit PASS MS 10/29/97 J *H not yet issued, but paid. • PLMC799 Final Inspection / / / / 10/28/97 Pending issuance. PASS MS 10/29/97 J *H PLMC800 Case Finaled / / / / 10/28/97 PASS MS 11/06/97 J*H • •