Permit CITY OFTIGARD
„,, \ DEVELOPMENT SERVICES PLUMBING PERMIT
� N IV I I II PERMIT # • PLM97 -0398
I,L - IL. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: i 0 / 06 / 97
PARCEL: 1S136DB -02502
l i SITE ADDRESS...: 11634 SW PACIFIC HWY
SUBDIVISION • ZONING: C —G
BLOCK • LOT • JURISDICTION: TIG
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 • 0 OTHER FIXTURES 0
TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0
WATER CLOSETS.: 0 WATER LINE (ft)...: 30
DISHWASHERS • 0 RAIN DRAIN (ft)...: 0
Remarks: Replace existing broken water line with 1" "L" copper pipe for an
existing commercial tenant occpy.
Owner: FEES
SUBWAY DEVELOPMENT CORP. type amount by date recpt
4840 SW SCHOOLS FERRY RD PRMT $ 30.00 GEO 10/06/97 97- 299811
PORTLAND OR 97225 5PCT $ 1.50 GEO 10/06/97 97- 299811
Phone #:
Contractor
SUNSET PLUMBING (GARY LONG)
8290 SW LANDAU
TIGARD OR 97223
Phone #: 245 -4926 $ 31.50 TOTAL
Reg #..: 000905
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Water Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 188 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 -0081 -0010 through OAR 952 -0881 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -1987.
A.
•,
Issued By: Permittee Signature: (
+++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ 4 + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 .■ Hall Blvd. Permit # Fe v 9Z__
Tiger "ci, OR 97223
(503) 639 -4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
' New Single Family Residences Only
� ❑ 1 BATH HOUSE $140.00 ❑ 2. BATH HOUSE $195.00
Job 1 \ 1914 SU 1 /1 (11 "C �� ❑ 3 BATH HOUSE $225.00
Address cnrisW° � av Fee includes all plumbing fixtures in the dwelling and the first 100 feet
■ f,, , J■6 r (Q of water service, sanitary sewer and storm sewer. See fees below.
°
Name ( nom ' °°" 1 QTY PRICE AMT
a /e)( POP P Sink 9.00
Miffing Merges Phone Lavatory 9.00
Owner p (' O Q(, Tub or Tub/Shower Comb. 9.00
WSW, Shower Only 9.00
Water Closet 9.00
"01°° "°1°° °' °1°"°" Dishwasher 9.00
Occupant M )w h ik Garbage Disposal 9.00
°,,,g A d?eq Phone Washing Machine 9.00
Io‘.)-e. Floor Drain 9.00
city/sm. zip Water Heater 9.00
Laundry Room Tray 9.00
Name Urinal 9.00
G I � h \s ' 1 p l A h i Other Fixtures (Specify) 9.00
Maim Address ` Ptmns 9.00
Contractor Ra o ti �_(. i ! t dr
q�( ^� 9.00
1I\ ce ,� ` I d, o`� l S Co
Sewer 1st 100' 3
o 9.00
30.00
s'°'° "°° "O f O' A1° O''
TO Sewer - ea. Addit. 100' 25.00
` 3 otigit Water Service 1st 100' / 30.00 3000
I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm & Rain Drain 1st 100' 30.00
I am registered with the Construction Contractor's Board, that the Storm & Rain Drain Addit 100' 25.00
numb- •iven is correct. (If exempt from State registration, please
giv- reaso below.) Mobile Home Space 25.00
Back Flow Prevention
!,■ i�di ! ID ' L 0 � • a Device or Anti - Pollution Device 9.00
• / Dour Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new 0 addition 0 alteration 0 repair 0 Catch Basin 9.00
to be done residential 0 non - residential 0 Insp. of Exist Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00
Proposed use of \
r),
building or property t P ls-\( (,. .
'(Except residential backflow
L \ y-1 fi, prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL 3O 06
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
5
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE / r
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
TOTAL 3/. S%
Special Conditions
Date issued by
1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 60 O 1 -I el x P.M. MST:
Location: I l I G , " �� L
�. r \1.1 BUP:
Tenant: , Suite: Bldg: MEC:
Contractor: v., - .14 L_ V t _ (& Phone: g...-Li S' ( 15 ) 0-10 PLM: / 7-03 ??
Owner: Phone: LC:
_,... A IPA / I "'' f , I / ! / f 'f r/ LR:
II !/ //i
f SIT:
BUILDING BLDG (con't) i L i i• a MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer/ torm
Footing Roof UndFI/Slab Rough -In Ceiling .V' ►
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MSC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved
Appr /Sdwlk Not Approved N® Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL
O Call for reinspection C) Reinspection fee of $ required before next inspection / O Unable to inspect
Inspector: c %��' ( /(
Date: � 97 Page / of