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Permit • -4 CITY TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #: PLM1999 -00112 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/20/99 SITE ADDRESS: 11455 SW PACIFIC HY PARCEL: 1S136AD -05901 W SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 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: Fire damage - replace existing fixtures. FEES Owner: Type By • Date Amount Receipt DAY'S INN PRMT GEO 4/20/99 $171.00 99- 314705 11455 SW PACIFIC HWY MISC GEO 4/20/99 $8.55 99- 314705 TIGARD, OR 97223 Total $179.55 Phone 1: Contractor: WATSON PLUMBING CO 7935 E BURNSIDE ST PORTLAND, OR 97215 REQUIRED INSPECTIONS Phone 1: 256 -3720 Misc. Inspection Final Inspection Reg #: LIC 111855 PLM 26 -602PB • 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 By: _ 4 ; f / Permittee Signature: Call (503 : %4175 by 7:00 P.M. for an inspection needed the next business day OITY'dit TIGARD Plumbing Permit Application Plan Check# 13125 SW HALL BLVD. Commercial and Residential Recd By TIGARD, OR 97223 Date Rec'd 44 , - / 4 (503) 639 -4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit #0 r1 /f9q -e0// Related SWR # /fff4 cadf 4 Called 4 / - 0 2 . 0- fl L #r 10,E 7944- g . , 5i g Name of Development/Project FIXTURES (individual) QTY PRICE AMT Job // Y `J A ) Sink 9.00 Address Stre et Address _ Suite , / �/ Lavatory fp 9.00 .5-9 / /4 7 � My (/'"/ e- / L J Tub or Tub /Shower Comb. s 9.00 S /s - .i Bldg # City /State Zip Shower Only 9.00 N Water Closet 6, 9.00 5 /Sl y r j /4t) /l f Dishwasher 9.00 Owner CI -- Address _ I Suite ` Garbage Disposal 9.00 NCI 7LtJ Mil / � / Washing Machine 9.00 SIty� Zip Phone 1� Floor Drain/Floor Sink 2° / 9.00 q -- Name 3" 9.00 - S / /k At 4° 9.00 Occupant Mailing Addre ' n / /�i ` Sui Water Heater 0 conversion 0 like kind 9.00 1 1 - � � �[ V V�` t' L . 2 i ) Gas piping requires a separate mechanical permit. City /Sta Zip Phone Laundry Room Tray / 9.00 L --- l 16 rn` Urinal 9.00 3N U -+ /Ri PL-g6- aO Other Fbctures (Specify) 9.00 Contractor in Address Suite ! 9.00 Lr 3 s 6 �t A.2NSt 0 E 9.00 Prior to permit /State 1 Zip hone Sewer -1st 100' 30.00 issuance, a copy `-1 ki 3 7D-.0 Sewer - each additional 100' 25.00 of all licenses are Oregon Const. Cont. Board Lic.# D e^ required if 61/ i --� --llama Water Service - 1st 100' 30.00 expired In COT P m ing uc #`` / ] D E xp. D Water Service - each additional 200' 25.00 database "- (IL p` Y D /� //9y Storm & Rain Drain -1st 100' 30.00 Name 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' 15.00 (Irrigation timing devices require a separate Describe work to be done: restricted energy permit.) New 0 Repair 0 Replace with like kind: Yes `iKirlo O Any Trap or Waste Not Connected to a Fixture 9.00 Residential 0 Commercial Catch Basin 9.00 Additional description of work: F, (? /9�� /F �� / , Pb Insp. of Existing Plumbing per/hr per/hr ' UA)/ v-5 YL N,? /�cf 40?)-7-Ai Specially Requested Inspections 40.00 per/hr Rain Drain, single family dwelling 30.00 Are you capping, move g replacing any fixtures? Grease Traps 9.00 Yes o If yes, see back of orm to indicate work performed by QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric or riser diagram is required it Quantity Total Is > 9 t WORK COULD RESULT IN INCREASED SEWER FEES. *SUBTOTAL I hereby acknowledge that I have read this application, that the information 1W/ given is correct, that I am the owner or authorized agent of the owner, and 5% SURCHARGE / r� that plans submitted are in with Oregon State Laws. / �/ C 'T/CC- 7 SI rIre o /AgRn ( � a (`t C f Required REVI 25% OF SUBTO /�/) d only fud If fixture qty. total Is > 9 TOTAL MO- C ontact Person Name Phone c 37 c9-0 *Minimum permit fee is $25 + 5% surcharge, except Residential Backflow Prevention Device, which is $15 + 5% surcharge G� r « 1 ? 5. • _ Q F, 0 "All New Commercial Buildings require plans with isometric or riser diagram (/ J and plan review 1:ldstslplumapp.doc 7/1/98 PLEASE COMPLETE: e w Moped ::: Replaced :I emoted /Capped • Sink Lavatory ( Tub or Tub /Shower Combination Shower Only Water Closet • Dishwasher Garbage Disposal Washing Machine Floor Drain /Floor Sink 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: 1:ldstMplumapp.doc 717/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested -- 71 ( Q Q ! AM X PM BLD Location i i L A SS f4 (, l Ayer Suite MEC Contact Person Ph 232 Z( PLM 19 Contractor Ph SWR BUILDING To Owner t2 /,i's ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab 19 101 " fi ✓1iL0 prlA._.1 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 PLUMBIe46 Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains in V PART FAIL ANICAL 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 // J 1 �Z Other Date ! 7 Inspector y% Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.