Permit t 1 CITY OF TIGARD PLUMBING PERMIT
A- , i n, DEVELOPMENT SERVICES PERMIT #: PLM2000 -00087
- '�' I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6 3 9 -4171 DATE ISSUED: 3/16100
SITE ADDRESS: 11686 SW PACIFIC HY PARCEL: 1S136CD -01700
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 1
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: Install Commercial Back Flow Prevention Device.
FEES
Owner:
Type By Date Amount Receipt
P & F PROPERTIES PRMT KJP 3/16/00 $50.00 0000698
834 W ST CLAIRE 5PCT KJP 3/16/00 $4.00 0000698
PORTLAND, OR 97205
Total $54.00
Phone 1: 225 -0700
•
Contractor:
PROGRASS LANDSCAPE SERVICES
29895 SW KINSMAN RD
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Phone 1: 682 -6076 RP /Backflow Preventer
Reg #: LIC 00006136 Final Inspection
PLM 11558
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 co ies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: `m
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
06/06/99 TL'E 10:57 FAX 503 598 1960 CITY OF TIG.ARD 0 002
CITY OF TIGARD ol so Plumbing Permit Application Plan Check* .
13125 SW HALL BLVD.sSe Commercial and Residential Rec'dBy
TIGARD, OR 97223 �Q ®® Date Recd
(503) 639 .4171 VAS g, 3 Da'e to P.E.
V lta' Print or Type Date to DST
i tete or illegible applications will not be accepted Permit# PLM zoco 000ry
t o Related SYLR x
Called
Name of Deveopment/Project ' FIX-TURES :( Individuall = ` - :. ;. :- :. :_ =:. 1 ; ..QZY :; : ..,PRICEt:: -AMT ' ,-
Job ffagnol(a Wi' r Video Sink 11.50
Address Street Addcess /'� I Suite Lavatory 11.50
i 6:, / 1`7 C the/ Tub or Tub/Shower Comb. ' 11.5C
Bldg # City /State fJ Zip Shower Only 11.50
nlcu•d o2 9
Name Water Closet 11.50
T• rn . S "1 C..JOYi Clsr.washer I 11.50
Owner Mail ng Address Suite Garbage Disposal 11.50
A th
O. 80x - ■ a r0 Washing Machine 11.50
.Sty / tate Zip c r Phone &Oa) Floor Cram /Floor Sink 2" 11
S ea - Wa- iC�l, ag3- (oD-oS .
Nair �
:7.555: Ot) ✓leg- 4' F. Ptrdp - 4 - tGS 4" 5OL`CK�?eM Na g Address Suite Water Heater 0 conversIon O like kind y w S C• b1re,., Gas piping requires a separate mechanical permit.
/S Zip Phone Laundry Room Tray 13
Ot ��j �Z� Urinal 11.50 •
LAMSCy Name Other Fixtures (Specify) 15.00
Pro Grass (_cwldscc p{, L) v
Contractor Mating Address Suite i
989S Ktnsm L0
Prier to permit City/Slate Zip Phone to a-- Sewer -1st 100' 38.00
Issuance. a copy 0;1 (&an OLLI4 or.Aloio (00710 tan) Sewer - each additional 100' 32.00
of all licenses are Oregon Conot. Cont. Board Lic.S Exp. 'D to
required if (p 13(0 31) -5 Water Service - 1st 100' 38.00
expired in COT Plumbing Lit # Fes. Date Water Service - each adoltlonal 20C' 32.00
database I Storm & Rain Drain - 1st 100' 38.00
Nang Storm & Rain Drain - each additional 100' 32.00
Architect Mobile Home Space 32.00
or - Mating Address Suite Commercial Back Flow Prevention Devise or Anti- / 32.00 3a dL
• Pollution Device
Engineer City/State Zip Phone Residential BacKftow Prevention Device" 19.00
(Irrigation timing devices require a separate
Describe work to be done: restricted energy permit.) .
New Repair 0 Repie with like kind: Yes O No O Any Trap or Waste Not Connected to a Fbdure 11.50
Residential C Commerdal'9,S+-'� Catch Basin 11.50
Additional description of work: F • Plurnbirg -
Insp. of Existing , lumbirg 50.00
/54"C.4 PYCLIe41.4161 d -'tCR. per/hr
you capping, moving or reolacin any fixtures? Specially Requested Inspections • p
Are er /n
Y 5 9 Y �erinr
Yes 0 No 0 Rain Drain, single family dwelling I 45.00 •
If yes, see back of form to indicate work performed by Grease Traps I 11.50
fixture. FAILURE TO ACCURATELY REPORT FIXTURE
WORK COULD RESULT IN INCREASED SEWER FEES. om QUANTITY TOTAL d ;.,. = .
I hereby acknowledge that i have read this application, that the information Isomeric cr rise: diagram is required If Quan:iry, Tctal is > 9 i . ilJ
given Is correct, that I am the owner or authorized agent of the owner, and 'SUBTOTAL
that plans submitted are in compliance with Cregon Slate Laws. _ .. _ :- '
Signature of 0 nee /Agent Da�e� 5 °,S SURCHARGE _
`
Contact Person amir, Phone � "PLAN REVIEW 25% OF SUBTOTAL - _ - - _
(age - (007( (9, J Required wily iifixture qty. toea1ls; - ... _ : .I
tU . OUSE; Ta.X. -0 r> c_-''_ - =`_ = ! ii g. -11: "=t�S! TOTAL - _ 4 :�a i -
p _. ' :r,iseti-!: : .:. f 4. -sir 9:d."_" c-_ -
tr Y- !. =U:-e • :X.Tr, -'.[2 Itiy�xT.` '1.` mi..c_'v :a = ?F- e'.: ^e :a te , c.A.t.,:rSi3,w �5: ?i::ii z;.+_ •- - i d . `:
�_ . r : mss•: r i FIP - ;__ si _ TMr! 4 'Minimum permit fee is $53 * 5% surcharge, except Residential Backttow
''"I - :r \ _ � `!'tiro '"_ ems.e any;.iz = r�r -if.nirr�._" n..
FCMI t 4� #icf itesr"�i tiff - 0 �6. r 4. Prevention Device, which is 525 * 5% surcharge
d >{ _ a "AII New Commercial Buildings require plans with isometric or riser diagram
t _'10� � IVe1 �8811ielRdT- .S1Ori�[t `W��_rii�cia�
and plan review
: ds :s[formslplumapp.dcc Sn M
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05/18/2000 Activities for Case #: PLM2000 -00087
3:28:36 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC003 APPlication received 03/13/2000 KJP MAIL No Hold KJP 03/16/2000
PLMC005 Permit Created 03/16/2000 KJP DONE No Hold KJP 03/16/2000 •
PLMC750 RP /Backflow Preventer No Hold KJP 03/16/2000
PLMC799 Final Inspection 03/31/2000 MRS PASS No Hold AKJ 04 /02/2000 • •
PLMCO50 (F) Issue permit 03/16/2000 KJP DONE No Hold KJP 03/16/2000
PLMC800 Case Finaled 04 /02/2000 AKJ DONE No Hold AKJ 04 /02/2000
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested 3,3 OD AM PM BLD
Location (1 g tP PaC ) Suite ME
Contact Person .,�1 Ph (z—% 4 2160-06077
Contractor Ph ,y ' SWR
BUILDING Tenant/Owner ►n Y1b ),fQ r ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire Sprinkler %'"
Fire Sprinkler /
Fire Alarm
W
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
ROTMBIN?
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
a' ar PART FAIL
k.iL 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
Other Date _ I Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.